NPIMap

Organization Active NPI

Keysar Center of Massage for the Medically Fragile

  • Specialist
  • Centralia, WA
National Provider Identifier
1649547126
Registry record updated Nov 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA60156485 Issued in WA
Legal business name
KEYSAR CENTER OF MASSAGE FOR THE MEDICALLY FRAGILE
Practice address
500 W Main St
Suite D
Centralia, WA 98531-4252
Phone
(360) 623-1214
Fax
(360) 623-1215
NPI assigned
Nov 28, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2011

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

Authorized official

Name
Kaci J Jones, LMP
Title
Owner
Phone
(206) 724-5393

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X MA60156485 WA Primary

Addresses

Primary practice location

500 W Main St
Suite D
Centralia, WA 98531-4252

Mailing address

500 W Main St
Suite D
Centralia, WA 98531-4252
Phone (360) 623-1214

Other identifiers 1

IdentifierTypeStateIssuer
MA60156485OtherWAINTRA ORAL

National Provider Directory

National Provider Directory

Locations

500 W Main St
Ste D
Centralia, WA 98531
Phone (360) 623-1214

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1322438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322438400000",
    "number": "1649547126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W MAIN ST",
            "address_2": "SUITE D",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985314252",
            "telephone_number": "360-623-1214",
            "fax_number": "360-623-1215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W MAIN ST",
            "address_2": "SUITE D",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985314252",
            "telephone_number": "360-623-1214",
            "fax_number": "360-623-1215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSAR CENTER OF MASSAGE FOR THE MEDICALLY FRAGILE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-28",
        "last_updated": "2011-11-28",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "KACI",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-724-5393",
        "authorized_official_credential": "LMP"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA60156485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTRA ORAL",
            "identifier": "MA60156485",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Centralia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2011; 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.