Individual provider Active NPI

Carol Etherington, L.M.P.

  • Massage Therapist
  • Issaquah, WA
National Provider Identifier
1811291123
Registry record updated Dec 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA 00012171 Issued in WA
Practice address
670 NW Gilman Blvd
Suite B2
Issaquah, WA 98027-2444
Phone
(425) 427-6562
NPI assigned
Dec 29, 2010
Last updated
Dec 29, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2010

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 MA 00012171 WA Primary

Addresses

Primary practice location

670 NW Gilman Blvd
Suite B2
Issaquah, WA 98027-2444

Mailing address

PO Box 51
Hobart, WA 98025-0051
Phone (425) 200-9432

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
MA 00012171WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1293580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293580800000",
    "number": "1811291123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51",
            "city": "HOBART",
            "state": "WA",
            "postal_code": "980250051",
            "telephone_number": "425-200-9432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 NW GILMAN BLVD",
            "address_2": "SUITE B2",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272444",
            "telephone_number": "425-427-6562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETHERINGTON",
        "first_name": "CAROL",
        "credential": "L.M.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-29",
        "last_updated": "2010-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA 00012171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Issaquah, WA

Sources for this page

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

Verify at the official NPI Registry.