Active NPI
Carol Ann Wiley, LMP
- Massage Therapist
- Redmond, WA
National Provider Identifier
1871662536
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA00010809
- Practice address
- 8310 165TH Ave NE
Life Changes Message
Redmond, WA 98052 - Phone
- (425) 785-8995
- NPI assigned
- Nov 7, 2006
- Sex
- Female
- Sole proprietor
- No
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 | MA00010809 | WA | Primary |
Addresses
Primary practice location
8310 165TH Ave NE
Life Changes Message
Redmond, WA 98052
Mailing address
5710 122ND Ave SE
#187
Bellevue, WA 98006
Phone (425) 649-0668
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 |
|---|---|---|---|
| MA00010809 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1871662536",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5710 122ND AVE SE",
"address_2": "#187",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "98006",
"telephone_number": "425-649-0668"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8310 165TH AVE NE",
"address_2": "LIFE CHANGES MESSAGE",
"city": "REDMOND",
"state": "WA",
"postal_code": "98052",
"telephone_number": "425-785-8995"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILEY",
"first_name": "CAROL",
"middle_name": "ANN",
"credential": "LMP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA00010809",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Redmond, 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.