Individual provider Active NPI

Reisa A. Cole, L.M.P.

  • Massage Therapist
  • Everett, WA
National Provider Identifier
1962679217
Registry record updated Jan 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA15347 Issued in WA
Practice address
1902 120TH PL SE,
Ste 102
Everett, WA 98208
Phone
(425) 268-6681
Fax
(425) 322-4424
NPI assigned
May 14, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA15347 WA Primary
Specialist 174400000X MA000105347 WA

Addresses

Primary practice location

1902 120TH PL SE,
Ste 102
Everett, WA 98208

Mailing address

1902 120TH PL SE,
Ste 102
Everett, WA 98208
Phone (425) 268-6681

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
MA000105347WAMDSpecialist
MA15347WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1210723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262822400000",
    "number": "1962679217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1902 120TH PL SE,",
            "address_2": "STE 102",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "98208",
            "telephone_number": "425-268-6681",
            "fax_number": "425-322-4424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1902 120TH PL SE,",
            "address_2": "STE 102",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "98208",
            "telephone_number": "425-268-6681",
            "fax_number": "425-322-4424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLE",
        "first_name": "REISA",
        "middle_name": "A.",
        "name_prefix": "Mrs.",
        "credential": "L.M.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-14",
        "last_updated": "2010-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA15347",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA000105347",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2010; 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.