Individual provider Active NPI

Camille J Knight

  • Massage Therapist
  • Edmonds, WA
National Provider Identifier
1154846079
Registry record updated Jul 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60159932 Issued in WA
Practice address
22005 76TH Ave W
Edmonds, WA 98026-7905
Phone
(425) 776-3800
Fax
(425) 776-3844
NPI assigned
Aug 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2021

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 MA60159932 WA Primary

Addresses

Primary practice location

22005 76TH Ave W
Edmonds, WA 98026-7905

Mailing address

22005 76TH Ave W
Edmonds, WA 98026-7905
Phone (425) 776-3800

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
MA60159932WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Health and Wellness Clinic PLLC CurrentSince Aug 1, 2021 Accepting new patients

Locations

22005 76th Ave W
Edmonds, WA 98026
Phone (425) 670-9097

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1502409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1154846079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22005 76TH AVE W",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267905",
            "telephone_number": "425-776-3800",
            "fax_number": "425-776-3844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22005 76TH AVE W",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267905",
            "telephone_number": "425-776-3800",
            "fax_number": "425-776-3844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNIGHT",
        "first_name": "CAMILLE",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-11",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60159932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmonds, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.