Individual provider Active NPI

Kimberly Ann Fingerson, LMT

  • Massage Therapist
  • Enumclaw, WA
National Provider Identifier
1265189369
Registry record updated Mar 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA61113201 Issued in WA
Practice address
2355 Griffin Ave Ste G
Enumclaw, WA 98022-2440
Phone
(206) 914-3267
NPI assigned
Mar 8, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2022

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 MA61113201 WA Primary

Addresses

Primary practice location

2355 Griffin Ave Ste G
Enumclaw, WA 98022-2440

Mailing address

459 Partlon St
Buckley, WA 98321-4601
Phone (206) 914-3267

Other identifiers 1

IdentifierTypeStateIssuer
MA61113201OtherWAMASSAGE LICENSE NUMBER

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
MA61113201WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1646697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1265189369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "459 PARTLON ST",
            "city": "BUCKLEY",
            "state": "WA",
            "postal_code": "983214601",
            "telephone_number": "206-914-3267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2355 GRIFFIN AVE STE G",
            "city": "ENUMCLAW",
            "state": "WA",
            "postal_code": "980222440",
            "telephone_number": "206-914-3267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FINGERSON",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-08",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA61113201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSAGE LICENSE NUMBER",
            "identifier": "MA61113201",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Enumclaw, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2022; 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.