Individual provider Active NPI

Sarah Michelle Willow, LMP

  • Massage Therapist
  • Kent, WA
National Provider Identifier
1710246590
Registry record updated Sep 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
60284012 Issued in WA
Practice address
1633 Maple LN
H-1
Kent, WA 98030-7458
Phone
(253) 880-8961
NPI assigned
May 14, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Health Chiropractor 111NX0100X 602668079 WA
Massage Therapist 225700000X 60284012 WA Primary

Addresses

Primary practice location

1633 Maple LN
H-1
Kent, WA 98030-7458

Mailing address

1405 Lewis St Apt 23
Centralia, WA 98531-1255
Phone (253) 880-8961

Other identifiers 1

IdentifierTypeStateIssuer
60284012OtherWAMASSAGE LICENSE

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
602668079WAMDOccupational Health Chiropractor
60284012WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1336953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1710246590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 LEWIS ST APT 23",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985311255",
            "telephone_number": "253-880-8961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1633 MAPLE LN",
            "address_2": "H-1",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980307458",
            "telephone_number": "253-880-8961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLOW",
        "first_name": "SARAH",
        "middle_name": "MICHELLE",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-14",
        "last_updated": "2021-09-16",
        "certification_date": "2021-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NX0100X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Occupational Health",
            "state": "WA",
            "license": "602668079",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "60284012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSAGE LICENSE",
            "identifier": "60284012",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kent, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; 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.