Individual provider Active NPI

Bevin Keely, L.M.P.

  • Massage Therapist
  • Seattle, WA
National Provider Identifier
1346330404
Registry record updated Apr 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00006264 Issued in WA
Practice address
311 1St Ave S Ste 215
Seattle, WA 98104-3419
Phone
(206) 343-9653
Fax
(206) 723-4645
NPI assigned
Oct 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2013

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 MA00006264 WA Primary

Addresses

Primary practice location

311 1St Ave S Ste 215
Seattle, WA 98104-3419

Mailing address

311 1St Ave S Ste 215
Seattle, WA 98104-3419
Phone (206) 343-9653

Other identifiers 1

IdentifierTypeStateIssuer
CA1088OtherWAREGENCE BLUE SHIELD ID

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
MA00006264WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365638400000",
    "number": "1346330404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 1ST AVE S STE 215",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981043419",
            "telephone_number": "206-343-9653",
            "fax_number": "206-723-4645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 1ST AVE S STE 215",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981043419",
            "telephone_number": "206-343-9653",
            "fax_number": "206-723-4645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEELY",
        "first_name": "BEVIN",
        "name_prefix": "Ms.",
        "credential": "L.M.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2013-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00006264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD ID",
            "identifier": "CA1088",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2013; 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.