Kirstie L Tharge, LMP

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA00016405 Issued in WA

Practice address

21806 103Rd Avenue CT E
#202
Graham, WA 98338-8115

Phone

(253) 847-3700

Fax

(253) 847-9622

NPI assigned

Aug 25, 2005

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Kirstie L Jackson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1184617052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 731269",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983730060",
            "telephone_number": "253-840-2313",
            "fax_number": "253-840-6340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21806 103RD AVENUE CT E",
            "address_2": "#202",
            "city": "GRAHAM",
            "state": "WA",
            "postal_code": "983388115",
            "telephone_number": "253-847-3700",
            "fax_number": "253-847-9622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THARGE",
        "first_name": "KIRSTIE",
        "middle_name": "L",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-25",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00016405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF L&I",
            "identifier": "178352",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRIME VICTIMS",
            "identifier": "8931496",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE B/S",
            "identifier": "3852TH",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIRSTIE",
            "last_name": "JACKSON",
            "middle_name": "L",
            "credential": "LMP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Massage Therapist in Graham, WA
• Providers in Graham, WA by specialty
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.