Individual provider Active NPI

Serendipity R Ancira, LMT

  • Massage Therapist
  • Seattle, WA
National Provider Identifier
1699250811
Registry record updated Oct 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60854043 Issued in WA
Practice address
2722 Eastlake Ave E Ste 360
Seattle, WA 98102-3143
Phone
(206) 324-8600
NPI assigned
Oct 3, 2018
Last updated
Oct 3, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA60854043 WA Primary

Addresses

Primary practice location

2722 Eastlake Ave E Ste 360
Seattle, WA 98102-3143

Mailing address

2722 Eastlake Ave E Ste 360
Seattle, WA 98102-3143
Phone (206) 324-8600

Other identifiers 1

IdentifierTypeStateIssuer
911805909OtherWAEASTLAKE CHIROPRACTIC CTR, PS

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

LicenseStateTypeSpecialty
MA60854043WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1538524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538524800000",
    "number": "1699250811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2722 EASTLAKE AVE E STE 360",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981023143",
            "telephone_number": "206-324-8600",
            "fax_number": "206-322-8520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2722 EASTLAKE AVE E STE 360",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981023143",
            "telephone_number": "206-324-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANCIRA",
        "first_name": "SERENDIPITY",
        "middle_name": "R",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-03",
        "last_updated": "2018-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60854043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EASTLAKE CHIROPRACTIC CTR, PS",
            "identifier": "911805909",
            "state": "WA"
        }
    ],
    "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 Oct 3, 2018; 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.