Active NPI
Dietrich Kiemle, L.M.P.
- Massage Therapist
- Bellevue, WA
National Provider Identifier
1043583461
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA 60193477
- Practice address
- 10448 SE 19TH St
Bellevue, WA 98004-7135 - Phone
- (425) 445-6553
- NPI assigned
- Feb 15, 2012
- Sex
- Male
- 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 | MA 60193477 | WA | Primary |
Addresses
Primary practice location
10448 SE 19TH St
Bellevue, WA 98004-7135
Mailing address
10448 SE 19TH St
Bellevue, WA 98004-7135
Phone (425) 445-6553
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 |
|---|---|---|---|
| MA 60193477 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329264000000",
"number": "1043583461",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10448 SE 19TH ST",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980047135",
"telephone_number": "425-445-6553"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10448 SE 19TH ST",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980047135",
"telephone_number": "425-445-6553"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIEMLE",
"first_name": "DIETRICH",
"credential": "L.M.P.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-02-15",
"last_updated": "2012-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA 60193477",
"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 Feb 15, 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.