Active NPI
Kyleen Rae Miller, MASSAGE THERAPIST
- Specialist
- Vancouver, WA
National Provider Identifier
1356572291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MA0018043
- Practice address
- 1307 NE 78TH St Ste 3
Vancouver, WA 98665-9675 - Phone
- (360) 573-1933
- Fax
- (360) 571-0143
- NPI assigned
- Jul 27, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Specialist | 174400000X | MA0018043 | WA | Primary |
Addresses
Primary practice location
1307 NE 78TH St Ste 3
Vancouver, WA 98665-9675
Mailing address
1307-B NE 78TH Street Suite #3
Vancouver, WA 98665
Phone (360) 573-1933
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 |
|---|---|---|---|
| MA0018043 | WA | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| NW Injury & Rehab Center, P.S. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Rehabilitation Chiropractor
- Vancouver, WA
- NPI 1619295524
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248652800000",
"number": "1356572291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1307-B NE 78TH STREET SUITE #3",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "98665",
"telephone_number": "360-573-1933",
"fax_number": "360-571-0143"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1307 NE 78TH ST STE 3",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986659675",
"telephone_number": "360-573-1933",
"fax_number": "360-571-0143"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "KYLEEN",
"middle_name": "RAE",
"name_prefix": "Mrs.",
"credential": "MASSAGE THERAPIST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-07-27",
"last_updated": "2009-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WA",
"license": "MA0018043",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.