Mark Sundlie, LMP

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA60035002 Issued in WA

Practice address

11911 NE 132ND St Ste 101
Kirkland, WA 98034-2900

Phone

(425) 814-8300

Fax

(425) 813-2004

NPI assigned

Oct 28, 2008

Last updated

Oct 28, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225152000000",
    "number": "1922251537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14190 SE 24TH ST",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980076252",
            "telephone_number": "425-922-8393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11911 NE 132ND ST STE 101",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980342900",
            "telephone_number": "425-814-8300",
            "fax_number": "425-813-2004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNDLIE",
        "first_name": "MARK",
        "name_prefix": "Mr.",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-28",
        "last_updated": "2008-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60035002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sung Therapy, LLC
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• Massage Therapist in Kirkland, WA
• Providers in Kirkland, WA by specialty
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2008; 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.