Kiley Serenity Roesch, L.M.P.

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA00018074 Issued in WA

Practice address

1495 NW Gilman Blvd
Suite 4
Issaquah, WA 98027-8975

Phone

(425) 394-1200

NPI assigned

Jul 25, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kiley Rowland Former name

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": "1343174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343174400000",
    "number": "1649526856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1495 NW GILMAN BLVD",
            "address_2": "SUITE 4",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980278975",
            "telephone_number": "425-394-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1495 NW GILMAN BLVD",
            "address_2": "SUITE 4",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980278975",
            "telephone_number": "425-394-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROESCH",
        "first_name": "KILEY",
        "middle_name": "SERENITY",
        "name_prefix": "Mrs.",
        "credential": "L.M.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-25",
        "last_updated": "2012-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00018074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KILEY",
            "last_name": "ROWLAND",
            "credential": "L.M.P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lauren Rocha, DNP, CPNP-PC
• Lewis B Rock III, M.D.
• Carsten Rode
• Wyatt Roderick
• Hannah M Rodrigues, PA-C
• Erin Roeter
• Callisto Rojas, DMD
• Joana Rojas
• Jennifer Romanowicz, DPT
• Ronald L. Furedy, MD, PS

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2012; 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.