Active NPI
Wesley C Kalitovic, LMP
- Massage Therapist
- Snohomish, WA
National Provider Identifier
1376831305
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA 60214967
- Practice address
- 1800 Bickford Ave Ste 201
Snohomish, WA 98290-1769 - Phone
- (425) 319-1123
- NPI assigned
- Jul 12, 2011
- Last updated
- Jul 12, 2011
- Sex
- Male
- 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 60214967 | WA | Primary |
Addresses
Primary practice location
1800 Bickford Ave Ste 201
Snohomish, WA 98290-1769
Mailing address
1309 39TH St
Everett, WA 98201-4806
Phone (425) 218-9753
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 60214967 | WA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Still Waters Massage Inc | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Massage Therapist
- Snohomish, WA
- NPI 1861822652
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1310428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1310428800000",
"number": "1376831305",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1309 39TH ST",
"city": "EVERETT",
"state": "WA",
"postal_code": "982014806",
"telephone_number": "425-218-9753"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 BICKFORD AVE STE 201",
"city": "SNOHOMISH",
"state": "WA",
"postal_code": "982901769",
"telephone_number": "425-319-1123"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KALITOVIC",
"first_name": "WESLEY",
"middle_name": "C",
"credential": "LMP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-07-12",
"last_updated": "2011-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA 60214967",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Snohomish, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.