Active NPI
Teri Kundert
- Contractor
- Bothell, WA
National Provider Identifier
1467652461
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- MA00023412
- Practice address
- 20611 Bothell Everett Hwy
Suite #G
Bothell, WA 98012 - Phone
- (425) 487-0487
- NPI assigned
- Jul 19, 2007
- Last updated
- Jul 19, 2007
- 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 |
|---|---|---|---|---|
| Contractor | 171W00000X | MA00023412 | WA | Primary |
Addresses
Primary practice location
20611 Bothell Everett Hwy
Suite #G
Bothell, WA 98012
Mailing address
20225 Bothell Everett Hwy
Apt #138
Bothell, WA 98012
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0158132 | Other | WA | MASSAGE THERAPIST |
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 |
|---|---|---|---|
| MA00023412 | WA | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184803200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184803200000",
"number": "1467652461",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20225 BOTHELL EVERETT HWY",
"address_2": "APT #138",
"city": "BOTHELL",
"state": "WA",
"postal_code": "98012"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20611 BOTHELL EVERETT HWY",
"address_2": "SUITE #G",
"city": "BOTHELL",
"state": "WA",
"postal_code": "98012",
"telephone_number": "425-487-0487"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUNDERT",
"first_name": "TERI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-07-19",
"last_updated": "2007-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "WA",
"license": "MA00023412",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MASSAGE THERAPIST",
"identifier": "0158132",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bothell, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.