Corallee Elizabeth Weber, LMP

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA00024666 Issued in WA

Practice address

111 K St NE
Ephrata, WA 98823-1747

Phone

(253) 905-6761

Fax

(253) 231-3475

NPI assigned

Nov 9, 2007

Last updated

Aug 29, 2022By the provider in NPPES

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

Other names 1

• Ms. Corallee Elizabeth Kowallis Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Competitive Edge Massage

  • Home Health Agency
  • Spanaway, WA
  • NPI 1134655137
  NPD (past) Authorized official

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

{
    "created_epoch": "1194566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1508046228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 K ST NE",
            "city": "EPHRATA",
            "state": "WA",
            "postal_code": "988231747",
            "telephone_number": "253-905-6761",
            "fax_number": "253-231-3475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 K ST NE",
            "city": "EPHRATA",
            "state": "WA",
            "postal_code": "988231747",
            "telephone_number": "253-905-6761",
            "fax_number": "253-231-3475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBER",
        "first_name": "CORALLEE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-09",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175L00000X",
            "taxonomy_group": "",
            "desc": "Homeopath",
            "state": "WA",
            "license": "MA00024666",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00024666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CORALLEE",
            "last_name": "KOWALLIS",
            "middle_name": "ELIZABETH",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Walia Adult Family Homecare LLC
• Walmart
• Walmart Inc.
• Michelle K Walsh
• Charles Michael Webberley, PA-C
• Aubrey Lynn Weirick, OT/R
• Wenatchee Valley Hospital (Confluence Health Ephrata)
• Patrice Marie Wenz, LMP
• William B Davis Inc PS (Davis Chiropractic Clinic)
• Brandon Jacob Wolther, D.C.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.

Verify at the official NPI Registry.