Active NPI
Keeley Sorensen, LMT
- Massage Therapist
- Renton, WA
National Provider Identifier
1457098238
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA60986684
- Practice address
- 11014 SE 192ND St
Renton, WA 98055-7432 - Phone
- (253) 852-8640
- Fax
- (253) 854-2690
- NPI assigned
- May 13, 2022
- Sex
- Female
- 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 | MA60986684 | WA | Primary |
Addresses
Primary practice location
11014 SE 192ND St
Renton, WA 98055-7432
Mailing address
1221 A St NE Apt B306
Auburn, WA 98002-4167
Phone (253) 880-7496
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 |
|---|---|---|---|
| MA60986684 | WA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marsh Chiropractic, PS | Massage Therapist | Past | Accepting new patients |
| Petrilli Chiropractic Services PS | Massage Therapist | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Massage Therapist
- Renton, WA
- NPI 1063570539
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1652400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652400000000",
"number": "1457098238",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1221 A ST NE APT B306",
"city": "AUBURN",
"state": "WA",
"postal_code": "980024167",
"telephone_number": "253-880-7496"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11014 SE 192ND ST",
"city": "RENTON",
"state": "WA",
"postal_code": "980557432",
"telephone_number": "253-852-8640",
"fax_number": "253-854-2690"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SORENSEN",
"first_name": "KEELEY",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-05-13",
"last_updated": "2022-05-13",
"certification_date": "2022-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA60986684",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Renton, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.