Penny Lee Vance

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA00023588 Issued in WA

Practice address

20611 Bothell Everett Hwy
Bothell, WA 98012-7146

Phone

(425) 487-0487

NPI assigned

May 11, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Penny Lee Vance Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699980912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 W CASINO RD APT 53",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982047968",
            "telephone_number": "425-267-0694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20611 BOTHELL EVERETT HWY",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980127146",
            "telephone_number": "425-487-0487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANCE",
        "first_name": "PENNY",
        "middle_name": "LEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00023588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMP.",
            "identifier": "0219208",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PENNY",
            "last_name": "VANCE",
            "middle_name": "LEE",
            "credential": "LMP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Priscila Vaillant Magalhaes de Melo
• Nicholas Van Baak
• Robyn Van Der Linden, LMP
• Larae Van Derschelden
• Allan Leslie Van Ness, DDS, MSD
• Philip Vande Pol, PT, DPT
• Jennifer Nicole Vandecar, OT
• Stephanie Christine Vanvalkenburgh Lohman, LICSW
• Ryan Michael Varian
• Mayra Vasquez, LANGUAGE INTERPRETER

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.