Individual provider Active NPI

Kellie Stockton, LMP

  • Massage Therapist
  • Spokane Valley, WA
National Provider Identifier
1154515484
Registry record updated Aug 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00014347 Issued in WA
Practice address
826 N Mullan Rd
Ste B
Spokane Valley, WA 99206-4094
Phone
(509) 928-8550
Fax
(509) 928-8592
NPI assigned
Aug 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2007

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 MA00014347 WA Primary

Addresses

Primary practice location

826 N Mullan Rd
Ste B
Spokane Valley, WA 99206-4094

Mailing address

826 N Mullan Rd
Ste B
Spokane Valley, WA 99206-4094
Phone (509) 928-8550

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
MA00014347WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188345600000",
    "number": "1154515484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "826 N MULLAN RD",
            "address_2": "STE B",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992064094",
            "telephone_number": "509-928-8550",
            "fax_number": "509-928-8592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "826 N MULLAN RD",
            "address_2": "STE B",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992064094",
            "telephone_number": "509-928-8550",
            "fax_number": "509-928-8592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOCKTON",
        "first_name": "KELLIE",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-29",
        "last_updated": "2007-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00014347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane Valley, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.