Individual provider Active NPI

Oksana Gavrishkevich, LMP

  • Massage Therapist
  • Kent, WA
National Provider Identifier
1396923959
Registry record updated May 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00024975 Issued in WA
Practice address
25854 108TH Ave SE
Kent, WA 98030-7737
Phone
(253) 852-2828
NPI assigned
Feb 6, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA00024975 WA Primary

Addresses

Primary practice location

25854 108TH Ave SE
Kent, WA 98030-7737

Mailing address

20925 130TH PL SE
Kent, WA 98031-2247
Phone (206) 719-3033

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

LicenseStateTypeSpecialty
MA00024975WAMDMassage Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1202256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211500800000",
    "number": "1396923959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20925 130TH PL SE",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980312247",
            "telephone_number": "206-719-3033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25854 108TH AVE SE",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980307737",
            "telephone_number": "253-852-2828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAVRISHKEVICH",
        "first_name": "OKSANA",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-06",
        "last_updated": "2008-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00024975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kent, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.