Individual provider Active NPI

Marla Susan Brandt, L.M.P.

  • Massage Therapist
  • Edmonds, WA
National Provider Identifier
1790997757
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00003245 Issued in WA
Practice address
307 Bell St Ste 102
Edmonds, WA 98020-3216
Phone
(425) 771-1751
NPI assigned
May 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 MA00003245 WA Primary

Addresses

Primary practice location

307 Bell St Ste 102
Edmonds, WA 98020-3216

Mailing address

3220 NW 69TH St
Seattle, WA 98117-6127
Phone (206) 782-8381

Other names 1

  • Ms. Marla Susan Brandt Professional name

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
MA00003245WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790997757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3220 NW 69TH ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981176127",
            "telephone_number": "206-782-8381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 BELL ST STE 102",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980203216",
            "telephone_number": "425-771-1751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDT",
        "first_name": "MARLA",
        "middle_name": "SUSAN",
        "name_prefix": "Ms.",
        "credential": "L.M.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00003245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARLA",
            "last_name": "BRANDT",
            "middle_name": "SUSAN",
            "prefix": "MS.",
            "credential": "L.M.P.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Edmonds, WA

Sources for this page

  • 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.