Active NPI
Kyan Shaffner, MA
- Massage Therapist
- Poulsbo, WA
National Provider Identifier
1710396288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA60370112
- Practice address
- 19586 10TH Ave NE
Suite 100
Poulsbo, WA 98370 - Phone
- (360) 697-2122
- NPI assigned
- Aug 8, 2014
- 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 | MA60370112 | WA | Primary |
Addresses
Primary practice location
19586 10TH Ave NE
Suite 100
Poulsbo, WA 98370
Mailing address
4060 Dyes Inlet Rd NW
Bremerton, WA 98312-1445
Phone (360) 536-2091
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA60370112 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407456000000",
"number": "1710396288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4060 DYES INLET RD NW",
"city": "BREMERTON",
"state": "WA",
"postal_code": "983121445",
"telephone_number": "360-536-2091"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19586 10TH AVE NE",
"address_2": "SUITE 100",
"city": "POULSBO",
"state": "WA",
"postal_code": "98370",
"telephone_number": "360-697-2122"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAFFNER",
"first_name": "KYAN",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-08-08",
"last_updated": "2014-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA60370112",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Poulsbo, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.