Active NPI
Destiny Kilmer, LMP
- Massage Therapist
- Bothell, WA
National Provider Identifier
1356601447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA 60280476
- Practice address
- 10024 Main St
#2C
Bothell, WA 98011-3464 - Phone
- (425) 485-1413
- NPI assigned
- May 22, 2012
- Sex
- Female
- 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 | MA 60280476 | WA | Primary |
Addresses
Primary practice location
10024 Main St
#2C
Bothell, WA 98011-3464
Mailing address
1220 NE Ballinger PL
Shoreline, WA 98155-1138
Phone (206) 478-5632
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 |
|---|---|---|---|
| MA 60280476 | WA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bothell Chiropractic & Wellness, PLLC | 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.
-
- Health Service Clinic/Center
- Bothell, WA
- NPI 1780851477
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1337644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1337644800000",
"number": "1356601447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1220 NE BALLINGER PL",
"city": "SHORELINE",
"state": "WA",
"postal_code": "981551138",
"telephone_number": "206-478-5632"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10024 MAIN ST",
"address_2": "#2C",
"city": "BOTHELL",
"state": "WA",
"postal_code": "980113464",
"telephone_number": "425-485-1413"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KILMER",
"first_name": "DESTINY",
"name_prefix": "Mrs.",
"credential": "LMP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-05-22",
"last_updated": "2012-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA 60280476",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bothell, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.