Active NPI
Sally Ellen Koester, LMP
- Massage Therapist
- Spokane Valley, WA
National Provider Identifier
1366852154
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 60405976
- Practice address
- 807 N Sullivan Rd
#1
Spokane Valley, WA 99037-8546 - Phone
- (509) 924-0504
- NPI assigned
- May 1, 2014
- 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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 60405976 | WA | Primary |
Addresses
Primary practice location
807 N Sullivan Rd
#1
Spokane Valley, WA 99037-8546
Mailing address
807 N Sullivan Rd
#1
Spokane Valley, WA 99037-8546
Phone (509) 924-0504
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
- Credentials
- Master of Theology
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60405976 | WA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spinal & Sports Care Clinic P S | Massage Therapist | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491782400000",
"number": "1366852154",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "807 N SULLIVAN RD",
"address_2": "#1",
"city": "SPOKANE VALLEY",
"state": "WA",
"postal_code": "990378546",
"telephone_number": "509-924-0504"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "807 N SULLIVAN RD",
"address_2": "#1",
"city": "SPOKANE VALLEY",
"state": "WA",
"postal_code": "990378546",
"telephone_number": "509-924-0504"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOESTER",
"first_name": "SALLY",
"middle_name": "ELLEN",
"name_prefix": "Mrs.",
"credential": "LMP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-05-01",
"last_updated": "2017-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "60405976",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spokane Valley, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.