Active NPI
Jillyn Marie Kossian, MA60773866
- Massage Therapist
- Gold Bar, WA
National Provider Identifier
1578086849
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA60773866
- Practice address
- 301 Croft Ave W
Gold Bar, WA 98251-9482 - Phone
- (360) 793-0904
- NPI assigned
- Jul 19, 2017
- 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 | MA60773866 | WA | Primary |
Addresses
Primary practice location
301 Croft Ave W
Gold Bar, WA 98251-9482
Mailing address
PO Box 175
Gold Bar, WA 98251-0175
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 |
|---|---|---|---|
| MA60773866 | WA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gold Bar Chiropractic P.L.L.C | Massage Therapist | Past | Accepting new patients |
Organizations & group practices 1
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": "1500422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1500422400000",
"number": "1578086849",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 175",
"city": "GOLD BAR",
"state": "WA",
"postal_code": "982510175"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 CROFT AVE W",
"city": "GOLD BAR",
"state": "WA",
"postal_code": "982519482",
"telephone_number": "360-793-0904"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOSSIAN",
"first_name": "JILLYN",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "MA60773866",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-07-19",
"last_updated": "2017-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA60773866",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gold Bar, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.