Active NPI
Shelly Vallem, LMT
- Massage Therapist
- Everett, WA
National Provider Identifier
1760031207
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA60998511
- Practice address
- 2824 Grand Ave Ste 102
Everett, WA 98201-3482 - Phone
- (425) 257-0177
- NPI assigned
- Sep 7, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 | MA60998511 | WA | Primary |
Addresses
Primary practice location
2824 Grand Ave Ste 102
Everett, WA 98201-3482
Mailing address
1621 98TH St NW
Tulalip, WA 98271-6423
Phone (360) 502-3456
Other practice location 1
1621 98th St NW
Tulalip, WA 98271-6423
Phone (360) 502-3456
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 |
|---|---|---|---|
| MA60998511 | WA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vitality Corporation | Single Specialty | Past | Accepting new patients |
| Renaissance Family Chiropractic, PLLC. | Single Specialty | Past | Accepting new patients |
Organizations & group practices 2
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": "1567814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567814400000",
"number": "1760031207",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1621 98TH ST NW",
"city": "TULALIP",
"state": "WA",
"postal_code": "982716423",
"telephone_number": "360-502-3456"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2824 GRAND AVE STE 102",
"city": "EVERETT",
"state": "WA",
"postal_code": "982013482",
"telephone_number": "425-257-0177"
}
],
"practiceLocations": [
{
"address_1": "1621 98th St NW",
"address_purpose": "LOCATION",
"city": "Tulalip",
"state": "WA",
"postal_code": "982716423",
"country_code": "US",
"telephone_number": "360-502-3456",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VALLEM",
"first_name": "SHELLY",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-09-07",
"last_updated": "2019-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA60998511",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Everett, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.