Kelly R Colello, LMP

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA00019960 Issued in WA

Practice address

17651 1St Ave. S.
Ste. #101
Normandy Park, WA 98148

Phone

(206) 241-3836

Fax

(206) 241-3967

NPI assigned

Sep 28, 2007

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 identifiers 1

Other names 1

• Kelly R Wanamaker Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Theology

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.

• Daryll G. Marshall-Inman DC Inc.

  • Chiropractor
  • Normandy Park, WA
  • NPI 1205934684
  NPD
• Leshaw Chiropractic PLLC

  • Sports Physician Chiropractor
  • Normandy Park, WA
  • NPI 1063064889

  Massage Therapist

  NPD

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

{
    "created_epoch": "1190937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1679760136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17651 1ST AVE. S.",
            "address_2": "STE. #101",
            "city": "NORMANDY PARK",
            "state": "WA",
            "postal_code": "98148",
            "telephone_number": "206-241-3836",
            "fax_number": "206-241-3967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17651 1ST AVE. S.",
            "address_2": "STE. #101",
            "city": "NORMANDY PARK",
            "state": "WA",
            "postal_code": "98148",
            "telephone_number": "206-241-3836",
            "fax_number": "206-241-3967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLELLO",
        "first_name": "KELLY",
        "middle_name": "R",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-28",
        "last_updated": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00019960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "0224172",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "WANAMAKER",
            "middle_name": "R",
            "credential": "LMP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dafna Chen, LMHC, CDP
• Sommer Rey Chetty, LMP
• Paul Allen Chilton, DDS
• Bean Choi, ND, EAMP
• Jacqueline Donna Chun, DPT
• Shawna Rose Costello, LMT
• Daryll G. Marshall-Inman DC Inc.
• Claudia M Delgado
• Rachael Diane Dial, LMT
• Dorothy F Diaz, FNP-C

• Massage Therapist in Normandy Park, WA
• Providers in Normandy Park, WA by specialty
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.

Verify at the official NPI Registry.