Mira Aqua Massage

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA60129874 Issued in WA

Legal business name

MIRA AQUA MASSAGE

Practice address

3516 204TH St SW
Apt A201
Lynnwood, WA 98036-9327

Phone

(206) 941-4543

NPI assigned

Nov 7, 2012

Organization subpart

No

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

Authorized official

Name

Amanda T McGee

Title

Owner/Massage Therapist

Phone

(206) 941-4543

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1352246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352246400000",
    "number": "1689928954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3516 204TH ST SW",
            "address_2": "APT A201",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980369327",
            "telephone_number": "206-941-4543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3516 204TH ST SW",
            "address_2": "APT A201",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980369327",
            "telephone_number": "206-941-4543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRA AQUA MASSAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-07",
        "last_updated": "2012-11-07",
        "status": "A",
        "authorized_official_last_name": "MCGEE",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER/MASSAGE THERAPIST",
        "authorized_official_telephone_number": "206-941-4543"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60129874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in Lynnwood, WA
• Providers in Lynnwood, WA by specialty
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2012; 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.