Shajan Joseph Kanacheril

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA61396888 Issued in WA

Practice address

4001 Capital Mall Dr SW
Olympia, WA 98502-8657

Phone

(360) 754-9792

NPI assigned

Oct 13, 2017

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1507852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1629589965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 MILROY ST NW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985024742",
            "telephone_number": "646-761-3322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 CAPITAL MALL DR SW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985028657",
            "telephone_number": "360-754-9792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANACHERIL",
        "first_name": "SHAJAN",
        "middle_name": "JOSEPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-13",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "P160783235",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA61396888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judy Wanjiku Kamau
• John Spencer Kamin, M.D.
• Paymon Kamkar, DDS
• Kathryn E Kammert, DO
• Stevi Kamphaus
• Min S Kang, MD
• Diana J Kangogo
• Alexandra Kania, PHARMD
• Meenakshi Kannappan
• Sukanya Kanthawatana, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; 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.