Active NPI
Wanda L. Skywater, LMP,NCTMB
- Massage Therapist
- Everett, WA
National Provider Identifier
1801926753
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA00021307
- Practice address
- 3819 Colby Ave
Everett, WA 98201-4912 - Phone
- (425) 339-8287
- Fax
- (425) 252-2325
- NPI assigned
- Mar 7, 2007
- 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 | MA00021307 | WA | Primary |
Addresses
Primary practice location
3819 Colby Ave
Everett, WA 98201-4912
Mailing address
3819 Colby Ave
Everett, WA 98201-4912
Phone (425) 339-8287
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0203583 | Other | WA | LABOR & INDUSTRIES |
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 |
|---|---|---|---|
| MA00021307 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1275004800000",
"number": "1801926753",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3819 COLBY AVE",
"city": "EVERETT",
"state": "WA",
"postal_code": "982014912",
"telephone_number": "425-339-8287",
"fax_number": "425-252-2325"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3819 COLBY AVE",
"city": "EVERETT",
"state": "WA",
"postal_code": "982014912",
"telephone_number": "425-339-8287",
"fax_number": "425-252-2325"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SKYWATER",
"first_name": "WANDA",
"middle_name": "L.",
"name_prefix": "Ms.",
"credential": "LMP,NCTMB",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-07",
"last_updated": "2010-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA00021307",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR & INDUSTRIES",
"identifier": "0203583",
"state": "WA"
}
],
"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 May 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.