Individual provider Active NPI

Olesya Kryvoruchko, LMT

  • Massage Therapist
  • Seattle, WA
National Provider Identifier
1235690561
Registry record updated Sep 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60945887 Issued in WA
Practice address
5236 California Ave SW Ste D
Seattle, WA 98136-1283
Phone
(206) 331-3999
NPI assigned
Mar 28, 2019
Last updated
Sep 6, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2019

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 MA60945887 WA Primary

Addresses

Primary practice location

5236 California Ave SW Ste D
Seattle, WA 98136-1283

Mailing address

1711 12TH Ave Apt 404
Seattle, WA 98122-3294
Phone (954) 857-7482

Other practice location 1

1222 E Madison St Ste D
Seattle, WA 98122-3909
Phone (206) 204-8255

Other practice location 2

1801 NW Market St Ste 408
Seattle, WA 98107-3901
Phone (206) 784-2800

Other practice location 3

704 Warren Ave N
Seattle, WA 98109-4027
Phone (206) 588-5079

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
MA60945887WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Opulent Healing, Inc., P.S. PastSince Mar 16, 2015 Accepting new patients
Monroe Therapeutic Massage, P.S. Massage Therapist PastSince Sep 8, 2019 Accepting new patients
M3 Bodyworks LLC Massage Therapist PastSince Sep 8, 2019 Accepting new patients
Monroe Therapeutic Massage PS Massage Therapist Past Accepting new patients
Northern Lights Massage, PLLC Massage Therapist PastSince Sep 8, 2019 Accepting new patients

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1553731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567728000000",
    "number": "1235690561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 12TH AVE APT 404",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981223294",
            "telephone_number": "954-857-7482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5236 CALIFORNIA AVE SW STE D",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981361283",
            "telephone_number": "206-331-3999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1222 E Madison St Ste D",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981223909",
            "country_code": "US",
            "telephone_number": "206-204-8255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1801 NW Market St Ste 408",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981073901",
            "country_code": "US",
            "telephone_number": "206-784-2800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "704 Warren Ave N",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981094027",
            "country_code": "US",
            "telephone_number": "206-588-5079",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRYVORUCHKO",
        "first_name": "OLESYA",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-28",
        "last_updated": "2019-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60945887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2019; 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.