Active NPI
Bradley Wathen, LMT
- Massage Therapist
- Kapaa, HI
National Provider Identifier
1275416570
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MAT-18005
- Practice address
- 4-356 Kuhio Highway
#113B
Kapaa, HI 96746 - Phone
- (530) 559-1664
- NPI assigned
- Jul 26, 2025
- Sex
- Male
- Sole proprietor
- No
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 | MAT-18005 | HI | Primary |
Addresses
Primary practice location
4-356 Kuhio Highway
#113B
Kapaa, HI 96746
Mailing address
5030 Laipo Road
#B
Kapaa, HI 96746
Phone (530) 559-1664
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 |
|---|---|---|---|
| MAT-18005 | HI | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1753488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753488000000",
"number": "1275416570",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5030 LAIPO ROAD",
"address_2": "#B",
"city": "KAPAA",
"state": "HI",
"postal_code": "96746",
"telephone_number": "530-559-1664"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4-356 KUHIO HIGHWAY",
"address_2": "#113B",
"city": "KAPAA",
"state": "HI",
"postal_code": "96746",
"telephone_number": "530-559-1664"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATHEN",
"first_name": "BRADLEY",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-07-26",
"last_updated": "2025-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "HI",
"license": "MAT-18005",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kapaa, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.