Active NPI
Nicole Charline Breeden, LMP
- Massage Therapist
- Seattle, WA
National Provider Identifier
1689912420
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 60190479
- Practice address
- 2656 SW Roxbury St
Seattle, WA 98126-4177 - Phone
- (206) 937-2000
- NPI assigned
- Jan 30, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 | 60190479 | WA | Primary |
Addresses
Primary practice location
2656 SW Roxbury St
Seattle, WA 98126-4177
Mailing address
6224 S 149TH PL
Tukwila, WA 98168-4631
Phone (808) 745-2573
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 |
|---|---|---|---|
| 60190479 | WA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Roxbury Spine and Wellness Clinic | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1359504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359504000000",
"number": "1689912420",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6224 S 149TH PL",
"city": "TUKWILA",
"state": "WA",
"postal_code": "981684631",
"telephone_number": "808-745-2573"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2656 SW ROXBURY ST",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981264177",
"telephone_number": "206-937-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BREEDEN",
"first_name": "NICOLE",
"middle_name": "CHARLINE",
"name_prefix": "Miss",
"credential": "LMP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-01-30",
"last_updated": "2013-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "60190479",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.