Individual provider Active NPI

Carl I Vanloo, L.M.P.

  • Massage Therapist
  • Seattle, WA
National Provider Identifier
1902938780
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00012365 Issued in WA
Practice address
402 22ND Ave S
Seattle, WA 98144-2269
Phone
(425) 745-4910
Fax
(425) 338-5709
NPI assigned
Mar 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 MA00012365 WA Primary

Addresses

Primary practice location

402 22ND Ave S
Seattle, WA 98144-2269

Mailing address

16030 Bothell Everett Hwy
Ste 200
Mill Creek, WA 98012-1741
Phone (425) 745-4910

Other identifiers 2

IdentifierTypeStateIssuer
0194907OtherWADEPT. OF L&I
2158VAOtherWAREGENCE

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
MA00012365WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The J. L. Donaldson Services Corp. Massage Therapist 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": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902938780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16030 BOTHELL EVERETT HWY",
            "address_2": "STE 200",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980121741",
            "telephone_number": "425-745-4910",
            "fax_number": "425-338-5709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 22ND AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981442269",
            "telephone_number": "425-745-4910",
            "fax_number": "425-338-5709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANLOO",
        "first_name": "CARL",
        "middle_name": "I",
        "name_prefix": "Mr.",
        "credential": "L.M.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00012365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT. OF L&I",
            "identifier": "0194907",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "2158VA",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, 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.

Verify at the official NPI Registry.