Individual provider Active NPI

Kirsten Etta Larson, LMP

  • Massage Therapist
  • Spokane, WA
National Provider Identifier
1164931507
Registry record updated Sep 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
60763632 Issued in WA
Practice address
3209 E 57TH Ave
Spokane, WA 99223
Phone
(509) 448-9398
NPI assigned
Sep 28, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2017

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 60763632 WA Primary

Addresses

Primary practice location

3209 E 57TH Ave
Spokane, WA 99223

Mailing address

3226 E 16TH Ave
Spokane, WA 99223
Phone (707) 690-8936

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
60763632WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cannon Sparks Massage LLC Massage Therapist Past Accepting new patients

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": "1506556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506556800000",
    "number": "1164931507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3226 E 16TH AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "99223",
            "telephone_number": "707-690-8936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3209 E 57TH AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "99223",
            "telephone_number": "509-448-9398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "KIRSTEN",
        "middle_name": "ETTA",
        "name_prefix": "Ms.",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-28",
        "last_updated": "2017-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "60763632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2017; 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.