Nicole Alexandria Ellis, LAC, LMP

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC 00002475 Issued in WA

Practice address

2809 Rockefeller Ave Ste a
Everett, WA 98201-3541

Phone

(425) 830-6765

NPI assigned

May 4, 2009

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1241395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241395200000",
    "number": "1679707871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1423 WETMORE AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982011635",
            "telephone_number": "425-830-6765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2809 ROCKEFELLER AVE STE A",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982013541",
            "telephone_number": "425-830-6765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "NICOLE",
        "middle_name": "ALEXANDRIA",
        "credential": "LAC, LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-04",
        "last_updated": "2009-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "WA",
            "license": "AC 00002475",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA 00018680",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Elliott
• Elizabeth Elliott, LMFT
• Caitlin Ellis
• Donald Lance Ellis, DONALD ELLIS LMP
• Hayley Ellis, SLP
• Peri Alyse Ellis
• Savannah Ellis
• Shannon Ellis, ARNP, AGACNP-BC
• Bailey James Ellison, PTA
• Emily Anne Ellison

• Acupuncturist in Everett, WA
• Providers in Everett, WA by specialty
• Acupuncturist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.