NPIMap

Organization Active NPI

Kitsap Therapeutic Medical Massage and Bodywork, LLC

  • Massage Therapist
  • Port Orchard, WA
National Provider Identifier
1326346768
Registry record updated Nov 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA000020549 Issued in WA
Legal business name
KITSAP THERAPEUTIC MEDICAL MASSAGE AND BODYWORK, LLC
Practice address
4275 SE Mile Hill Dr
Suite B
Port Orchard, WA 98366-3934
Phone
(360) 710-3299
NPI assigned
Mar 9, 2011
Last updated
Nov 14, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2016

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

Authorized official

Name
Julene Nikolac, LMP
Title
Owner
Phone
(360) 710-3299

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA000020549 WA Primary

Addresses

Primary practice location

4275 SE Mile Hill Dr
Suite B
Port Orchard, WA 98366-3934

Mailing address

PO Box 4988
South Colby, WA 98384-0988
Phone (360) 710-8097

National Provider Directory

National Provider Directory

Locations

4275 SE Mile Hill Dr
Unit B
Port Orchard, WA 98366
Phone (360) 710-3299

NPI Registry JSON

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

{
    "created_epoch": "1299628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479081600000",
    "number": "1326346768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4988",
            "city": "SOUTH COLBY",
            "state": "WA",
            "postal_code": "983840988",
            "telephone_number": "360-710-8097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4275 SE MILE HILL DR",
            "address_2": "SUITE B",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983663934",
            "telephone_number": "360-710-3299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KITSAP THERAPEUTIC MEDICAL MASSAGE AND BODYWORK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-09",
        "last_updated": "2016-11-14",
        "status": "A",
        "authorized_official_last_name": "NIKOLAC",
        "authorized_official_first_name": "JULENE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-710-3299",
        "authorized_official_credential": "LMP"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA000020549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orchard, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.