Active NPI
Stephanie M Wilson, LMP
- Massage Therapist
- Seattle, WA
National Provider Identifier
1962685859
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA00025057
- Practice address
- 2319 N 45TH St
Suite 308
Seattle, WA 98103-6982 - Phone
- (206) 265-0676
- NPI assigned
- Dec 13, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA00025057 | WA | Primary |
Addresses
Primary practice location
2319 N 45TH St
Suite 308
Seattle, WA 98103-6982
Mailing address
14341 Stone Ave N
Seattle, WA 98133-7020
Phone (206) 265-0676
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
| License | State | Type | Specialty |
|---|---|---|---|
| MA00025057 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1197504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328227200000",
"number": "1962685859",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14341 STONE AVE N",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981337020",
"telephone_number": "206-265-0676"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2319 N 45TH ST",
"address_2": "SUITE 308",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981036982",
"telephone_number": "206-265-0676"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "STEPHANIE",
"middle_name": "M",
"credential": "LMP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-12-13",
"last_updated": "2012-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA00025057",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.