NPIMap

Individual provider Active NPI

Kimberly Breshears

  • Massage Therapist
  • Bellevue, WA
National Provider Identifier
1033464417
Registry record updated Jul 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60215476 Issued in WA
Practice address
1611 116TH Ave NE Ste 200
Bellevue, WA 98004-3064
Phone
(425) 455-0088
NPI assigned
Jul 20, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2012

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 MA60215476 WA Primary

Addresses

Primary practice location

1611 116TH Ave NE Ste 200
Bellevue, WA 98004-3064

Mailing address

PO Box 1644
Issaquah, WA 98027-0066
Phone (213) 200-2934

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
MA60215476WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Soma Therapeutics,PLLC Massage Therapist Past Accepting new patients
Monroe Therapeutic Massage PS Massage Therapist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1342742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342828800000",
    "number": "1033464417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1644",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980270066",
            "telephone_number": "213-200-2934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 116TH AVE NE STE 200",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043064",
            "telephone_number": "425-455-0088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRESHEARS",
        "first_name": "KIMBERLY",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-20",
        "last_updated": "2012-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60215476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.

Verify at the official NPI Registry.