Carrie Kim, MASSAGE THERAPIST

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA61505898 Issued in WA

Practice address

6840 Fort Dent Way Ste 120
Tukwila, WA 98188-2595

Phone

(206) 809-0070

NPI assigned

Nov 17, 2023

Reactivated

Mar 25, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1700179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1407621683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6840 FORT DENT WAY STE 120",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981882595",
            "telephone_number": "206-591-0722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6840 FORT DENT WAY STE 120",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981882595",
            "telephone_number": "206-809-0070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "CARRIE",
        "credential": "MASSAGE THERAPIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-17",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "deactivation_date": "2024-03-18",
        "reactivation_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA61505898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peyapong Khoeun
• Michael Claude Kilbourne, MA, LMHC
• Megan Jane Kilcup, PHARMD
• Ahyoung Amber Kim, DMD
• Byung Kyu Kim, M.D.
• Christine Kim, OTR, OTD
• Daeyang Kim
• Mary Kim
• Minki Kim, DDS
• Brita E Kimmerly

• Massage Therapist in Tukwila, WA
• Providers in Tukwila, WA by specialty
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 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.

Verify at the official NPI Registry.