Individual provider Active NPI

Daenna Lynne January, LMT

  • Massage Therapist
  • Bellevue, WA
National Provider Identifier
1801618921
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA61612604 Issued in WA
Practice address
1 Lake Bellevue Dr Ste 208
Bellevue, WA 98005-2417
Phone
(561) 945-7683
NPI assigned
Oct 29, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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 MA61612604 WA Primary

Addresses

Primary practice location

1 Lake Bellevue Dr Ste 208
Bellevue, WA 98005-2417

Mailing address

2426 70TH Ave SE
Mercer Island, WA 98040-2511
Phone (561) 945-7683

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
MA61612604WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Northwest Massage and Cryotherapy, LLC Massage Therapist CurrentSince Dec 8, 2024 Accepting new patients

Locations

1 Lake Bellevue Dr
Ste 208
Bellevue, WA 98005
Phone (561) 945-7683

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": "1730160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1801618921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2426 70TH AVE SE",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "980402511",
            "telephone_number": "561-945-7683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LAKE BELLEVUE DR STE 208",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980052417",
            "telephone_number": "561-945-7683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANUARY",
        "first_name": "DAENNA",
        "middle_name": "LYNNE",
        "name_prefix": "Ms.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-29",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA61612604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; 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.