Individual provider Active NPI

Stacy Claire McDowell Mitchell

  • Massage Therapist
  • Issaquah, WA
National Provider Identifier
1871994178
Registry record updated Sep 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60493074 Issued in WA
Practice address
465 Rainier Blvd N
Issaquah, WA 98027-2826
Phone
(425) 392-5321
NPI assigned
Sep 6, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2014

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 MA60493074 WA Primary

Addresses

Primary practice location

465 Rainier Blvd N
Issaquah, WA 98027-2826

Mailing address

10915 296TH Ave NE
Carnation, WA 98014-9029
Phone (425) 761-5703

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
MA60493074WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
James E. Fitzpatrick, D.C. PS Past Accepting new patients

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": "1409961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409961600000",
    "number": "1871994178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10915 296TH AVE NE",
            "city": "CARNATION",
            "state": "WA",
            "postal_code": "980149029",
            "telephone_number": "425-761-5703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 RAINIER BLVD N",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272826",
            "telephone_number": "425-392-5321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "STACY",
        "middle_name": "CLAIRE MCDOWELL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-06",
        "last_updated": "2014-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60493074",
            "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 Sep 6, 2014; 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.