Active NPI
Michelle Mask
- Licensed Practical Nurse
- Federal Way, WA
National Provider Identifier
1689396533
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- LP60764869
- Practice address
- 33330 8TH Ave S
Federal Way, WA 98003-6325 - Phone
- (253) 945-2000
- NPI assigned
- Sep 16, 2022
- Last updated
- Sep 16, 2022
- 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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | LP60764869 | WA | Primary |
Addresses
Primary practice location
33330 8TH Ave S
Federal Way, WA 98003-6325
Mailing address
PO Box 27414
Federal Way, WA 98093-4414
Phone (253) 331-3446
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 |
|---|---|---|---|
| LP60764869 | WA | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663286400000",
"number": "1689396533",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 27414",
"city": "FEDERAL WAY",
"state": "WA",
"postal_code": "980934414",
"telephone_number": "253-331-3446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "33330 8TH AVE S",
"city": "FEDERAL WAY",
"state": "WA",
"postal_code": "980036325",
"telephone_number": "253-945-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASK",
"first_name": "MICHELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-16",
"last_updated": "2022-09-16",
"certification_date": "2022-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "WA",
"license": "LP60764869",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Federal Way, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.