Individual provider Active NPI

Breanna Renee Lazenby, LMP

  • Massage Therapist
  • Kirkland, WA
National Provider Identifier
1720325202
Registry record updated Jan 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60258449 Issued in WA
Practice address
6515 132ND Ave NE
Kirkland, WA 98033-8628
Phone
(425) 822-4326
Fax
(425) 827-3572
NPI assigned
Jan 3, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2013

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 MA60258449 WA Primary

Addresses

Primary practice location

6515 132ND Ave NE
Kirkland, WA 98033-8628

Mailing address

6515 132ND Ave NE
Kirkland, WA 98033-8628
Phone (425) 822-4326

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
MA60258449WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1357171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357171200000",
    "number": "1720325202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6515 132ND AVE NE",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980338628",
            "telephone_number": "425-822-4326",
            "fax_number": "425-827-3572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6515 132ND AVE NE",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980338628",
            "telephone_number": "425-822-4326",
            "fax_number": "425-827-3572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZENBY",
        "first_name": "BREANNA",
        "middle_name": "RENEE",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-03",
        "last_updated": "2013-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60258449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2013; 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.