Mitsunaga Christopher Kubo, LMP

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA60681370 Issued in WA

Practice address

17650 140TH Ave SE
Ste B-07
Renton, WA 98058-6814

Phone

(425) 430-0700

Fax

(425) 430-0710

NPI assigned

Aug 8, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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": "1470614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472515200000",
    "number": "1245784206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2222",
            "fax_number": "630-759-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17650 140TH AVE SE",
            "address_2": "STE B-07",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980586814",
            "telephone_number": "425-430-0700",
            "fax_number": "425-430-0710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBO",
        "first_name": "MITSUNAGA",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Mr.",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-08",
        "last_updated": "2016-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60681370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ashley Lauren Krombach
• Jessica Krzycki
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• Brian H Kumasaka, MD
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• Wendy Kuo-Eveland, O.D.
• Leland Kuykendall

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2016; 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.