Issac Ambrose Konkler, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA60970420 Issued in WA

Practice address

11015 NE Fourth Plain Blvd
Ste B
Vancouver, WA 98662

Phone

(360) 892-0451

Fax

(360) 892-1601

NPI assigned

Jul 15, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• E Group Wa LLC

  • Chiropractor
  • Vancouver, WA
  • NPI 1285266080
  NPD
• Lembke Chiropractic Clinic PS

  • Chiropractor
  • Vancouver, WA
  • NPI 1578747622
  NPD
• Breathe Yoga and Massage, LLC

  • Mechanotherapist
  • Vancouver, WA
  • NPI 1740561752
  NPD (past)

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

{
    "created_epoch": "1563148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1669024030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11015 NE FOURTH PLAIN BLVD STE B",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11015 NE FOURTH PLAIN BLVD",
            "address_2": "STE B",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98662",
            "telephone_number": "360-892-0451",
            "fax_number": "360-892-1601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONKLER",
        "first_name": "ISSAC",
        "middle_name": "AMBROSE",
        "name_prefix": "Mr.",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-15",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60970420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Violetta Alekseevna Kolesnikova, M.D.
• Kathryn Stegen Kolibaba, M.D.
• Elizabeth Kolombet, RN
• Caitlin Jade Kong
• Athena Nicole Konicki
• Hyunwoo Koo, CNA
• Jennifer W Kooistra, RN, BSN
• Brittany Koontz
• Isabelle E Koontz
• Samuel J Kopman, DVM

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.