Individual provider Active NPI

Kathleen Elizabeth Frederick, L.M.P.

  • Massage Therapist
  • Spokane Valley, WA
National Provider Identifier
1710294251
Registry record updated Sep 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60178813 Issued in WA
Practice address
325 S Sullivan Rd
Suite B
Spokane Valley, WA 99037-6000
Phone
(509) 928-9098
Fax
(509) 928-9091
NPI assigned
Sep 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA60178813 WA Primary

Addresses

Primary practice location

325 S Sullivan Rd
Suite B
Spokane Valley, WA 99037-6000

Mailing address

325 S Sullivan Rd
Suite B
Spokane Valley, WA 99037-6000
Phone (509) 928-9098

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

LicenseStateTypeSpecialty
MA60178813WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1283472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283472000000",
    "number": "1710294251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 S SULLIVAN RD",
            "address_2": "SUITE B",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "990376000",
            "telephone_number": "509-928-9098",
            "fax_number": "509-928-9091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 S SULLIVAN RD",
            "address_2": "SUITE B",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "990376000",
            "telephone_number": "509-928-9098",
            "fax_number": "509-928-9091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "KATHLEEN",
        "middle_name": "ELIZABETH",
        "credential": "L.M.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-03",
        "last_updated": "2010-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60178813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane Valley, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2010; 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.