Kelli Kay Riddle

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA00018568 Issued in WA

Practice address

4775 Ballard Ave NW
Seattle, WA 98107-4810

Phone

(206) 778-0063

Fax

(206) 297-0838

NPI assigned

Jan 17, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Rejuvenation of Ballard

  • Massage Therapist
  • Seattle, WA
  • NPI 1730233669
  NPD (past)

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699827832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4775 BALLARD AVE NW",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981074810",
            "telephone_number": "206-778-0063",
            "fax_number": "206-297-0838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4775 BALLARD AVE NW",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981074810",
            "telephone_number": "206-778-0063",
            "fax_number": "206-297-0838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDDLE",
        "first_name": "KELLI",
        "middle_name": "KAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00018568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kim M Riddell, M.D.
• Stanley R Riddell, MD
• Jacqueline Vasen Riddick, M.D.
• Stephanie Alexandra Riddiford, LMP
• Jennifer M Riddle, LMP
• Steven M Riddle, RPH
• Robbin Marie Rideout
• Monally Deureng Ridep
• Megan Vickery Rider, ARNP
• Jennifer L Ridgeley, RN

• Massage Therapist in Seattle, WA
• Providers in Seattle, 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 8, 2007; 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.