Individual provider Active NPI

Marilyn Alice Overcast, LMT

  • Massage Therapist
  • Lake Forest Park, WA
National Provider Identifier
1932247343
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00005713 Issued in WA
Practice address
19635 40TH PL NE
Lake Forest Park, WA 98155-2823
Phone
(206) 989-2100
Fax
(206) 366-0448
NPI assigned
Feb 1, 2007
Sex
Female
Sole proprietor
Yes

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 MA00005713 WA Primary

Addresses

Primary practice location

19635 40TH PL NE
Lake Forest Park, WA 98155-2823

Mailing address

19635 40TH PL NE
Lake Forest Park, WA 98155-2823
Phone (206) 361-9229

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
MA00005713WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932247343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19635 40TH PL NE",
            "city": "LAKE FOREST PARK",
            "state": "WA",
            "postal_code": "981552823",
            "telephone_number": "206-361-9229",
            "fax_number": "206-366-0448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19635 40TH PL NE",
            "city": "LAKE FOREST PARK",
            "state": "WA",
            "postal_code": "981552823",
            "telephone_number": "206-989-2100",
            "fax_number": "206-366-0448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVERCAST",
        "first_name": "MARILYN",
        "middle_name": "ALICE",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00005713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest Park, 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.