NPIMap

Organization Active NPI

Edmonds Massage Center

  • Massage Therapist
  • Mountlake Terrace, WA
National Provider Identifier
1700080256
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00012309 Issued in WA
Legal business name
EDMONDS MASSAGE CENTER
Practice address
6603 220TH St SW Ste 1C
Mountlake Terrace, WA 98043-2186
Phone
(425) 776-1056
NPI assigned
Jun 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Kelly Kozelisky
Title
President
Phone
(425) 776-1056

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225700000X MA00012309 WA Primary

Addresses

Primary practice location

6603 220TH St SW Ste 1C
Mountlake Terrace, WA 98043-2186

Mailing address

6603 220TH St SW Ste 1C
Mountlake Terrace, WA 98043-2186
Phone (425) 776-1056

National Provider Directory

National Provider Directory

Locations

6603 220th St SW
Ste 1C
Mountlake Terrace, WA 98043
Phone (425) 776-1056

Practitioners & affiliated clinicians

Practitioners 9

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": "1181520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700080256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6603 220TH ST SW STE 1C",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980432186",
            "telephone_number": "425-776-1056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6603 220TH ST SW STE 1C",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980432186",
            "telephone_number": "425-776-1056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDMONDS MASSAGE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KOZELISKY",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-776-1056"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00012309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountlake Terrace, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.