Individual provider Active NPI

Katelyn A Krech, LMP

  • Massage Therapist
  • Silverdale, WA
National Provider Identifier
1487966180
Registry record updated Dec 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA 60152367 Issued in WA
Practice address
10513 Silverdale Way NW
Suite 102
Silverdale, WA 98383-9499
Phone
(360) 698-4411
Fax
(360) 698-6953
NPI assigned
Jul 9, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2010

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 MA 60152367 WA Primary

Addresses

Primary practice location

10513 Silverdale Way NW
Suite 102
Silverdale, WA 98383-9499

Mailing address

20455 1St Ave NE
#A103
Poulsbo, WA 98370-9319
Phone (360) 710-9413

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
MA 60152367WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Wellness and Rehabilitation PLLC PastSince Aug 31, 2012 Accepting new patients
Advanced Wellness & Rehabilitation PLLC 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.

NPI Registry JSON

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

{
    "created_epoch": "1278633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292198400000",
    "number": "1487966180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20455 1ST AVE NE",
            "address_2": "#A103",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983709319",
            "telephone_number": "360-710-9413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10513 SILVERDALE WAY NW",
            "address_2": "SUITE 102",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983839499",
            "telephone_number": "360-698-4411",
            "fax_number": "360-698-6953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRECH",
        "first_name": "KATELYN",
        "middle_name": "A",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-09",
        "last_updated": "2010-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA 60152367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silverdale, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2010; 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.