Keila Marie Stafford, MA61656832

Individual provider Active NPI Massage Therapist · La Conner, WA

NPI 1235939265 · NPPES record last updated Mar 18, 2025

Key facts

NPI
1235939265
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
MA61656832 (WA)
Practice address
112 Morris St
Suite C
La Conner, WA 98257-7015
Phone
(360) 333-2586
NPI assigned
Mar 18, 2025
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
MA61656832WAMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA61656832 WA Yes

Addresses

Primary practice location

112 Morris St
Suite C
La Conner, WA 98257-7015

Mailing address

2775 State Route 9
Sedro Woolley, WA 98284-7626
Phone (360) 333-2586

Other practice location 1

2775 State Route 9
Sedro Woolley, WA 98284-7626
Phone (360) 333-2586

Other providers in La Conner, WA

All providers in La Conner, WA · Massage Therapist in Washington

Sources for this page

Verify at the official NPI Registry.