Active NPI
Cristin Jane Kloeck, LMP
- Massage Therapist
- North Bend, WA
National Provider Identifier
1215290721
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA00022481
- Practice address
- 318 E Park St
North Bend, WA 98045-8200 - Phone
- (425) 442-1634
- NPI assigned
- Jun 19, 2012
- Reactivated
- Apr 19, 2024
- Last updated
- Apr 19, 2024
- 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 | MA00022481 | WA | Primary |
Addresses
Primary practice location
318 E Park St
North Bend, WA 98045-8200
Mailing address
P.O. Box 44
Snoqualmie Pass, WA 98068
Phone (425) 442-1633
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 |
|---|---|---|---|
| MA00022481 | WA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Garage Massage Therapy, PLLC | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba The Garage Massage
- Massage Therapist
- Issaquah, WA
- NPI 1841696002
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713484800000",
"number": "1215290721",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 44",
"city": "SNOQUALMIE PASS",
"state": "WA",
"postal_code": "98068",
"telephone_number": "425-442-1633"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "318 E PARK ST",
"city": "NORTH BEND",
"state": "WA",
"postal_code": "980458200",
"telephone_number": "425-442-1634"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLOECK",
"first_name": "CRISTIN",
"middle_name": "JANE",
"credential": "LMP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-06-19",
"last_updated": "2024-04-19",
"deactivation_date": "2017-05-26",
"reactivation_date": "2024-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA00022481",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Bend, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.