NPIMap

Organization Active NPI

Revive Therapeutics

Doing business as Revive, Revive Active Therapy

  • Massage Therapist
  • Seattle, WA
National Provider Identifier
1699092395
Registry record updated Oct 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
00023864 Issued in WA
Legal business name
REVIVE THERAPEUTICS
Doing business as
Revive, Revive Active Therapy
Practice address
5100 S Dawson St
Ste 104
Seattle, WA 98118-2100
Phone
(206) 760-1448
Fax
(206) 760-1730
NPI assigned
Apr 21, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2010

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

Authorized official

Name
Dana Kirkwood-WattsNPI 1699939017
Title
Owner
Phone
(206) 760-1448

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 171100000X 00000488 WA
Massage TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225700000X 00023864 WA Primary

Addresses

Primary practice location

5100 S Dawson St
Ste 104
Seattle, WA 98118-2100

Mailing address

5100 S Dawson St
Ste 104
Seattle, WA 98118-2100
Phone (206) 760-1448

Other names 1

  • Revive, Revive Active Therapy Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1271808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286236800000",
    "number": "1699092395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 S DAWSON ST",
            "address_2": "STE 104",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981182100",
            "telephone_number": "206-760-1448",
            "fax_number": "206-760-1730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 S DAWSON ST",
            "address_2": "STE 104",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981182100",
            "telephone_number": "206-760-1448",
            "fax_number": "206-760-1730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE THERAPEUTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-21",
        "last_updated": "2010-10-05",
        "status": "A",
        "authorized_official_last_name": "KIRKWOOD-WATTS",
        "authorized_official_first_name": "DANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-760-1448"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "WA",
            "license": "00000488",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "00023864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Revive, Revive Active Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 5, 2010; 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.