Active NPI
Matthew Evan Kendall, LMP
- Massage Therapist
- Seattle, WA
National Provider Identifier
1396579264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA61549051
- Practice address
- 4464 Fremont Ave N Ste 2
Seattle, WA 98103-7273 - Phone
- (206) 801-9251
- NPI assigned
- Aug 31, 2024
- 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 | MA61549051 | WA | Primary |
Addresses
Primary practice location
4464 Fremont Ave N Ste 2
Seattle, WA 98103-7273
Mailing address
1020 NE 63Rd St Unit 415
Seattle, WA 98115-6673
Phone (831) 233-4913
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 |
|---|---|---|---|
| MA61549051 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1725062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725062400000",
"number": "1396579264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1020 NE 63RD ST UNIT 415",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981156673",
"telephone_number": "831-233-4913"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4464 FREMONT AVE N STE 2",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981037273",
"telephone_number": "206-801-9251"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENDALL",
"first_name": "MATTHEW",
"middle_name": "EVAN",
"credential": "LMP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-08-31",
"last_updated": "2024-08-31",
"certification_date": "2024-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA61549051",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.