Shannon Michelle Peterson, L.M.P.

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA60177035 Issued in WA

Practice address

11811 Mukilteo Speedway
200
Mukilteo, WA 98275-5442

Phone

(425) 381-3866

NPI assigned

Aug 2, 2012

Last updated

Jul 2, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1343865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404259200000",
    "number": "1912253360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5227 84TH ST SW APT 8",
            "city": "MUKILTEO",
            "state": "WA",
            "postal_code": "982752968",
            "telephone_number": "425-232-4087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11811 MUKILTEO SPEEDWAY",
            "address_2": "200",
            "city": "MUKILTEO",
            "state": "WA",
            "postal_code": "982755442",
            "telephone_number": "425-381-3866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "SHANNON",
        "middle_name": "MICHELLE",
        "credential": "L.M.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-02",
        "last_updated": "2014-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60177035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Yuan Wei Peng, RPH
• Scott Alan Penington, PT, DPT
• Arvrin Peralta, DPT
• Rebekah Ann Peralta, LMP
• Mary L Peters, MA, LMHC
• Sara Doll Petry, M.D.
• Pham Walter PLLC (Mukilteo Dental Center)
• Lananh Thi Pham, R.C.
• Nhi T Pham, D.D.S.
• Navdeep Singh Phambota, RC

• Massage Therapist in Mukilteo, WA
• Providers in Mukilteo, WA by specialty
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.