Active NPI
Kylan Robyn Skinner, LMP
- Massage Therapist
- Poulsbo, WA
National Provider Identifier
1730201351
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA00016445
- Practice address
- 19068 Jensen Way NE
Suite 4B
Poulsbo, WA 98370 - Phone
- (360) 271-2268
- Fax
- (360) 779-5373
- NPI assigned
- Apr 4, 2007
- 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 | MA00016445 | WA | Primary |
Addresses
Primary practice location
19068 Jensen Way NE
Suite 4B
Poulsbo, WA 98370
Mailing address
16661 NW Church Rd
Seabeck, WA 98380
Phone (360) 271-2268
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 |
|---|---|---|---|
| MA00016445 | WA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Bodywork Therapy Inc | Massage Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Massage Therapist
- Poulsbo, WA
- NPI 1861814329
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1730201351",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16661 NW CHURCH RD",
"city": "SEABECK",
"state": "WA",
"postal_code": "98380",
"telephone_number": "360-271-2268"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19068 JENSEN WAY NE",
"address_2": "SUITE 4B",
"city": "POULSBO",
"state": "WA",
"postal_code": "98370",
"telephone_number": "360-271-2268",
"fax_number": "360-779-5373"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SKINNER",
"first_name": "KYLAN",
"middle_name": "ROBYN",
"name_prefix": "Miss",
"credential": "LMP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA00016445",
"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 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.