Individual provider Active NPI

Kimberly Christian Evans, LMP

  • Massage Therapist
  • Sunnyside, WA
National Provider Identifier
1871691261
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00022761 Issued in WA
Practice address
1120 So 4TH St
Sunnyside, WA 98944-1120
Phone
(509) 837-2600
Fax
(509) 837-2291
NPI assigned
Sep 20, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 MA00022761 WA Primary

Addresses

Primary practice location

1120 So 4TH St
Sunnyside, WA 98944-1120

Mailing address

1340 Independence Rd
Outlook, WA 98938-1340
Phone (509) 837-2989

Other identifiers 1

IdentifierTypeStateIssuer
0211056OtherWAL & I

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
MA00022761WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Yakima Valley Chiropractic Center PS PastSince Jan 1, 1998 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871691261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 INDEPENDENCE RD",
            "city": "OUTLOOK",
            "state": "WA",
            "postal_code": "989381340",
            "telephone_number": "509-837-2989",
            "fax_number": "509-305-7044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 SO 4TH ST",
            "city": "SUNNYSIDE",
            "state": "WA",
            "postal_code": "989441120",
            "telephone_number": "509-837-2600",
            "fax_number": "509-837-2291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "KIMBERLY",
        "middle_name": "CHRISTIAN",
        "name_prefix": "Miss",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00022761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I",
            "identifier": "0211056",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyside, 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.

Verify at the official NPI Registry.