Michelle L Sullivan, LMP

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA60394974 Issued in WA

Practice address

4322 Rucker Ave
Everett, WA 98203-2233

Phone

(425) 258-5454

NPI assigned

Jul 29, 2013

Last updated

Jul 29, 2013By 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

Other names 1

• Michelle L Lucena Former name

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": "1375056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375056000000",
    "number": "1952743155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5",
            "city": "LAKE STEVENS",
            "state": "WA",
            "postal_code": "982580005",
            "telephone_number": "425-299-9745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4322 RUCKER AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982032233",
            "telephone_number": "425-258-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MICHELLE",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-29",
        "last_updated": "2013-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60394974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "LUCENA",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ceyhan Sukaya
• Clare Sullivan, MSW
• Janna Ruberry Sullivan, PTA
• Lisa Marie Sullivan, PSY.D.
• Mara Sullivan
• Stephen Sullivan
• Sumit K. Makker DDS, PLLC
• Diane Summers, RD
• Sydnie Alana Rhae Summers, BA
• Summit Cardiology PS

• Massage Therapist in Everett, WA
• Providers in Everett, 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 29, 2013; 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.