Active NPI
McKenzie Nicole Evans, LMP
- Massage Therapist
- Edmonds, WA
National Provider Identifier
1679072250
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA60827443
- Practice address
- 115 4TH Ave S Ste C
Edmonds, WA 98020-3515 - Phone
- (425) 778-2838
- Fax
- (425) 640-7423
- NPI assigned
- Feb 8, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA60827443 | WA | Primary |
Addresses
Primary practice location
115 4TH Ave S Ste C
Edmonds, WA 98020-3515
Mailing address
115 4TH Ave S Ste C
Edmonds, WA 98020-3515
Phone (425) 778-2838
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA60827443 | WA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Quan Yin Acupuncture, LLC | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Acupuncturist
- Edmonds, WA
- NPI 1033435870
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1518048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1518048000000",
"number": "1679072250",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 4TH AVE S STE C",
"city": "EDMONDS",
"state": "WA",
"postal_code": "980203515",
"telephone_number": "425-778-2838",
"fax_number": "425-640-7423"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 4TH AVE S STE C",
"city": "EDMONDS",
"state": "WA",
"postal_code": "980203515",
"telephone_number": "425-778-2838",
"fax_number": "425-640-7423"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "MCKENZIE",
"middle_name": "NICOLE",
"credential": "LMP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-08",
"last_updated": "2018-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA60827443",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edmonds, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.