Active NPI
Kim Autumn Fisher
- Massage Therapist
- Seattle, WA
National Provider Identifier
1710512470
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA60847339
- Practice address
- 2722 Eastlake Ave E Ste 360
Seattle, WA 98102-3143 - Phone
- (206) 324-8600
- NPI assigned
- Mar 3, 2020
- Sex
- Female
- Sole proprietor
- No
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 | MA60847339 | WA | Primary |
Addresses
Primary practice location
2722 Eastlake Ave E Ste 360
Seattle, WA 98102-3143
Mailing address
2852 Eastlake Ave E Apt 58
Seattle, WA 98102-3031
Phone (206) 453-9493
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
| License | State | Type | Specialty |
|---|---|---|---|
| MA60847339 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583193600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583193600000",
"number": "1710512470",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2852 EASTLAKE AVE E APT 58",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981023031",
"telephone_number": "206-453-9493"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2722 EASTLAKE AVE E STE 360",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981023143",
"telephone_number": "206-324-8600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISHER",
"first_name": "KIM",
"middle_name": "AUTUMN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-03",
"last_updated": "2020-03-03",
"certification_date": "2020-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA60847339",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.