Active NPI
Elana Marie Brassard-Kuffler
- Massage Therapist
- Black Diamond, WA
National Provider Identifier
1386299238
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MASS.MA.60303938
- Practice address
- 30741 3Rd Ave Ste 120
Black Diamond, WA 98010-9791 - Phone
- (360) 886-5492
- NPI assigned
- Aug 7, 2019
- 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 | MASS.MA.60303938 | WA | Primary |
Addresses
Primary practice location
30741 3Rd Ave Ste 120
Black Diamond, WA 98010-9791
Mailing address
2786 Olie Ann PL
Enumclaw, WA 98022-5041
Phone (253) 797-3682
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 |
|---|---|---|---|
| MASS.MA.60303938 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565136000000",
"number": "1386299238",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2786 OLIE ANN PL",
"city": "ENUMCLAW",
"state": "WA",
"postal_code": "980225041",
"telephone_number": "253-797-3682"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30741 3RD AVE STE 120",
"city": "BLACK DIAMOND",
"state": "WA",
"postal_code": "980109791",
"telephone_number": "360-886-5492"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRASSARD-KUFFLER",
"first_name": "ELANA",
"middle_name": "MARIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-08-07",
"last_updated": "2019-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MASS.MA.60303938",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Black Diamond, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.