Active NPI
Kathy Pflueger Mennella, LMP
- Massage Therapist
- Burien, WA
National Provider Identifier
1164555702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA00001247
- Practice address
- 16259 Sylvester Rd SW
Ste.102
Burien, WA 98166-3049 - Phone
- (206) 242-5186
- NPI assigned
- Mar 13, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA00001247 | WA | Primary |
Addresses
Primary practice location
16259 Sylvester Rd SW
Ste.102
Burien, WA 98166-3049
Mailing address
715 SW Colewood LN
Normandy Park, WA 98166-3900
Phone (206) 244-6037
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
| License | State | Type | Specialty |
|---|---|---|---|
| MA00001247 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1164555702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "715 SW COLEWOOD LN",
"city": "NORMANDY PARK",
"state": "WA",
"postal_code": "981663900",
"telephone_number": "206-244-6037"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16259 SYLVESTER RD SW",
"address_2": "STE.102",
"city": "BURIEN",
"state": "WA",
"postal_code": "981663049",
"telephone_number": "206-242-5186"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENNELLA",
"first_name": "KATHY",
"middle_name": "PFLUEGER",
"credential": "LMP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA00001247",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burien, WA
Sources for this page
- 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.