Individual provider Active NPI

Alexa Jean Peden, LMT

  • Massage Therapist
  • Shoreline, WA
National Provider Identifier
1932606324
Registry record updated Apr 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
60842511 Issued in WA
Practice address
15827 11TH Ave NE
Shoreline, WA 98155-6301
Phone
(425) 466-7453
Fax
(425) 466-7453
NPI assigned
Apr 11, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2018

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 60842511 WA Primary

Addresses

Primary practice location

15827 11TH Ave NE
Shoreline, WA 98155-6301

Mailing address

15827 11TH Ave NE
Shoreline, WA 98155-6301
Phone (425) 466-7453

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
60842511WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1523404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523404800000",
    "number": "1932606324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15827 11TH AVE NE",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981556301",
            "telephone_number": "425-466-7453",
            "fax_number": "425-466-7453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15827 11TH AVE NE",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981556301",
            "telephone_number": "425-466-7453",
            "fax_number": "425-466-7453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDEN",
        "first_name": "ALEXA",
        "middle_name": "JEAN",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-11",
        "last_updated": "2018-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "60842511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoreline, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2018; 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.