Individual provider Active NPI

Kevin Pedrey, LMP

  • Massage Therapist
  • Sequim, WA
National Provider Identifier
1639544943
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60303219 Issued in WA
Practice address
244 W Washington St
Sequim, WA 98382
Phone
(360) 477-8553
Fax
(360) 443-4203
NPI assigned
Dec 11, 2015
Last updated
Aug 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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 MA60303219 WA Primary

Addresses

Primary practice location

244 W Washington St
Sequim, WA 98382

Mailing address

244 W Washington St
Sequim, WA 98382
Phone (360) 477-8553

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
MA60303219WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Fitness LLC Massage Therapist CurrentSince Aug 17, 2025 Accepting new patients
Northwest Massage and Holistic Healing Center Massage Therapist Past Accepting new patients

Locations

244 W Washington St
Sequim, WA 98382
Phone (360) 477-8553

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1449792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1639544943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "244 W WASHINGTON ST",
            "city": "SEQUIM",
            "state": "WA",
            "postal_code": "98382",
            "telephone_number": "360-477-8553",
            "fax_number": "360-443-4203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "244 W WASHINGTON ST",
            "city": "SEQUIM",
            "state": "WA",
            "postal_code": "98382",
            "telephone_number": "360-477-8553",
            "fax_number": "360-443-4203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDREY",
        "first_name": "KEVIN",
        "name_prefix": "Mr.",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-12-11",
        "last_updated": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60303219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sequim, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2025; 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.