Kathleen Diane Nielson, LICENSED MASSAGE PRA

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA5015 Issued in WA

Practice address

20200 37TH Ave NE
Lake Forest Park, WA 98155-1657

Phone

(206) 365-2350

NPI assigned

Nov 24, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073689980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20200 37TH AVE NE",
            "city": "LAKE FOREST PARK",
            "state": "WA",
            "postal_code": "981551657",
            "telephone_number": "206-365-2350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20200 37TH AVE NE",
            "city": "LAKE FOREST PARK",
            "state": "WA",
            "postal_code": "981551657",
            "telephone_number": "206-365-2350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIELSON",
        "first_name": "KATHLEEN",
        "middle_name": "DIANE",
        "name_prefix": "Ms.",
        "credential": "LICENSED MASSAGE PRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA5015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "63212",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA USHC",
            "identifier": "5829693",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "NI6014",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas Ndamele, PHARM.D.
• Abigail Nelson, LMHCA
• Leslie S Newton, MD
• Amoy A NG, MD
• Khang Nhat Nguyen, PHARMACY TECHNICIAN
• Nina Svino DDS PLLC
• Northwest Kidney Centers
• Dijana Novak
• Rebecca Lynn Olson, ARNP
• Sandra Oreilly, RN

• Massage Therapist in Lake Forest Park, WA
• Providers in Lake Forest Park, WA by specialty
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.