Individual provider Active NPI

Andrea M Reeser, LMP

  • Massage Therapist
  • Kent, WA
National Provider Identifier
1174704571
Registry record updated Nov 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00023230 Issued in WA
Practice address
12932 SE Kent Kangley Rd
#438
Kent, WA 98030-7940
Phone
(253) 630-6614
Fax
(253) 630-6624
NPI assigned
Nov 14, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 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 MA00023230 WA Primary

Addresses

Primary practice location

12932 SE Kent Kangley Rd
#438
Kent, WA 98030-7940

Mailing address

12932 SE Kent Kangley Rd
#438
Kent, WA 98030-7940
Phone (253) 630-6614

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
MA00023230WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194998400000",
    "number": "1174704571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12932 SE KENT KANGLEY RD",
            "address_2": "#438",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980307940",
            "telephone_number": "253-630-6614",
            "fax_number": "253-630-6624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12932 SE KENT KANGLEY RD",
            "address_2": "#438",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980307940",
            "telephone_number": "253-630-6614",
            "fax_number": "253-630-6624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REESER",
        "first_name": "ANDREA",
        "middle_name": "M",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-14",
        "last_updated": "2007-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00023230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kent, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.