Jessica Kinkelaar Campbell, LMP

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA60275438 Issued in WA

Practice address

12815 Canyon Rd E Ste R
Puyallup, WA 98373-5104

Phone

(253) 686-4606

Fax

(253) 446-6022

NPI assigned

Mar 14, 2013

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 names 1

• Jessica Kinkelaar Smith Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1363219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1154662195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 273",
            "city": "GRAHAM",
            "state": "WA",
            "postal_code": "983380273",
            "telephone_number": "253-686-4606",
            "fax_number": "253-446-6022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12815 CANYON RD E STE R",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983735104",
            "telephone_number": "253-686-4606",
            "fax_number": "253-446-6022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "JESSICA",
        "middle_name": "KINKELAAR",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-14",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60275438",
            "primary": true
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "WA",
            "license": "NC10096120",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "SMITH",
            "middle_name": "KINKELAAR",
            "credential": "LMP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Julie Camp, M.A., LMHC
• Allyson Campanelli Spence, DO
• Angela Campbell
• Brooke Campbell, LICSW
• Chantress L Campbell
• Lorie Lynn Campbell, M.ED., LMHCA
• Nanelle Campbell, RN
• Joshua Andrew Canady, LMHC
• David Cano Jr., LMT
• Nicole B Cantos, NP

• 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 Aug 25, 2022; 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.