Active NPI
Kenna Keral Holland
- Massage Therapist
- Lynnwood, WA
National Provider Identifier
1356778047
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA 60363650
- Practice address
- 18904 Highway 99 Ste K
Lynnwood, WA 98036-5219 - Phone
- (253) 280-7951
- NPI assigned
- Sep 26, 2013
- 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 60363650 | WA | Primary |
Addresses
Primary practice location
18904 Highway 99 Ste K
Lynnwood, WA 98036-5219
Mailing address
10913 54TH Dr NE
Marysville, WA 98271-8806
Phone (425) 622-7764
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 60363650 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380153600000",
"number": "1356778047",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10913 54TH DR NE",
"city": "MARYSVILLE",
"state": "WA",
"postal_code": "982718806",
"telephone_number": "425-622-7764"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18904 HIGHWAY 99 STE K",
"city": "LYNNWOOD",
"state": "WA",
"postal_code": "980365219",
"telephone_number": "253-280-7951"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLAND",
"first_name": "KENNA",
"middle_name": "KERAL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-09-26",
"last_updated": "2013-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA 60363650",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lynnwood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.