Active NPI
Kaylee Willman
- Massage Therapist
- Kingston, WA
National Provider Identifier
1679312284
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA61414790
- Practice address
- 26076 Iowa Ave NE # B-1
Kingston, WA 98346-9683 - Phone
- (360) 271-8806
- NPI assigned
- May 22, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA61414790 | WA | Primary |
Addresses
Primary practice location
26076 Iowa Ave NE # B-1
Kingston, WA 98346-9683
Mailing address
8202 NE State Hwy 104
Suite 102, PMB 140
Kingston, WA 98346
Phone (360) 271-8806
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
| License | State | Type | Specialty |
|---|---|---|---|
| MA61414790 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1716336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716336000000",
"number": "1679312284",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8202 NE STATE HWY 104",
"address_2": "SUITE 102, PMB 140",
"city": "KINGSTON",
"state": "WA",
"postal_code": "98346",
"telephone_number": "360-271-8806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26076 IOWA AVE NE # B-1",
"city": "KINGSTON",
"state": "WA",
"postal_code": "983469683",
"telephone_number": "360-271-8806"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLMAN",
"first_name": "KAYLEE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-05-22",
"last_updated": "2024-05-22",
"certification_date": "2024-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA61414790",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kingston, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.