Active NPI
Charles Hillyard
- Massage Therapist
- Seattle, WA
National Provider Identifier
1710648233
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA60103844
- Practice address
- 9714 3Rd Ave NE Ste 103
Seattle, WA 98115-2047 - Phone
- (206) 527-9709
- NPI assigned
- Jan 6, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA60103844 | WA | Primary |
Addresses
Primary practice location
9714 3Rd Ave NE Ste 103
Seattle, WA 98115-2047
Mailing address
19830 Bagley Dr N Apt V304
Shoreline, WA 98133-2722
Phone (360) 774-0236
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
| License | State | Type | Specialty |
|---|---|---|---|
| MA60103844 | WA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Green Lake Massage Health Center, LLC | Massage Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1641427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641427200000",
"number": "1710648233",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19830 BAGLEY DR N APT V304",
"city": "SHORELINE",
"state": "WA",
"postal_code": "981332722",
"telephone_number": "360-774-0236"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9714 3RD AVE NE STE 103",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981152047",
"telephone_number": "206-527-9709"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HILLYARD",
"first_name": "CHARLES",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-01-06",
"last_updated": "2022-01-06",
"certification_date": "2022-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA60103844",
"primary": true
}
],
"identifiers": [],
"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 Jan 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.