Active NPI
Katreena M Hallberg, LMP
- Massage Therapist
- Eatonville, WA
National Provider Identifier
1013570043
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA60947935
- Practice address
- 205 Center St E
Suite a
Eatonville, WA 98328-9832 - Phone
- (253) 469-4942
- NPI assigned
- Apr 16, 2019
- 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 | MA60947935 | WA | Primary |
Addresses
Primary practice location
205 Center St E
Suite a
Eatonville, WA 98328-9832
Mailing address
PO Box 1674
Eatonville, WA 98328-1674
Phone (360) 402-3967
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 |
|---|---|---|---|
| MA60947935 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555372800000",
"number": "1013570043",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1674",
"city": "EATONVILLE",
"state": "WA",
"postal_code": "983281674",
"telephone_number": "360-402-3967"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 CENTER ST E",
"address_2": "SUITE A",
"city": "EATONVILLE",
"state": "WA",
"postal_code": "983289832",
"telephone_number": "253-469-4942"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALLBERG",
"first_name": "KATREENA",
"middle_name": "M",
"credential": "LMP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-04-16",
"last_updated": "2019-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA60947935",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eatonville, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.