Kalena Anna Soares-Kakulu, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA00022974 Issued in WA

Practice address

7503 144TH St E
Puyallup, WA 98375-8269

Phone

(360) 970-6309

NPI assigned

Mar 7, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Karen Perez-Santiago Former name

Electronic endpoints 1

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": "1457308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617321600000",
    "number": "1104286921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8839 DAFFODIL LN SE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985131767",
            "telephone_number": "360-706-9204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7503 144TH ST E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983758269",
            "telephone_number": "360-970-6309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOARES-KAKULU",
        "first_name": "KALENA",
        "middle_name": "ANNA",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-07",
        "last_updated": "2021-04-02",
        "certification_date": "2021-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "M00022974",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00022974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104286921",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "jillian@detailedbillingsolutions.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8839 Daffodil Ln SE",
            "city": "Olympia",
            "state": "WA",
            "country_code": "US",
            "postal_code": "985131767",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KAREN",
            "last_name": "PEREZ-SANTIAGO",
            "credential": "LMP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Massage Therapist in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2021; 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.