Individual provider Active NPI

Kandi Lamay Elray Jarrell, LMP

  • Massage Therapist
  • Burien, WA
National Provider Identifier
1023337813
Registry record updated May 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60132570 Issued in WA
Practice address
15811 Ambaum Blvd SW
Suite 110
Burien, WA 98166-3066
Phone
(206) 242-8211
Fax
(206) 242-0162
NPI assigned
May 19, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2010

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 MA60132570 WA Primary

Addresses

Primary practice location

15811 Ambaum Blvd SW
Suite 110
Burien, WA 98166-3066

Mailing address

1122 NE Kelly Ave Apt K136
Gresham, OR 97030-3977
Phone (503) 766-2332

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
MA60132570WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1274227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274227200000",
    "number": "1023337813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 NE KELLY AVE APT K136",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303977",
            "telephone_number": "503-766-2332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15811 AMBAUM BLVD SW",
            "address_2": "SUITE 110",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981663066",
            "telephone_number": "206-242-8211",
            "fax_number": "206-242-0162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARRELL",
        "first_name": "KANDI",
        "middle_name": "LAMAY ELRAY",
        "name_prefix": "Mrs.",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-19",
        "last_updated": "2010-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60132570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burien, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.