Individual provider Active NPI

Kendall McAnally, LAC

  • Acupuncturist
  • Vancouver, WA
National Provider Identifier
1881135515
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
61529334 Issued in WA
Practice address
100 E 19TH St Ste 500
Vancouver, WA 98663-3385
Phone
(360) 313-6465
NPI assigned
Mar 14, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X 61529334 WA Primary

Addresses

Primary practice location

100 E 19TH St Ste 500
Vancouver, WA 98663-3385

Mailing address

1330 NE 136TH Ave Apt 155
Vancouver, WA 98684-5970
Phone (512) 906-8685

Other practice location 1

1330 NE 136th Ave Apt 155
Vancouver, WA 98684-5970
Phone (512) 906-8685

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
61529334WAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Fern & Fae Massage CurrentSince Nov 10, 2024 Accepting new patients

Locations

100 E 19th St
Ste 500
Vancouver, WA 98663
Phone (360) 313-6465

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.

NPI Registry JSON

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

{
    "created_epoch": "1489449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1881135515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 NE 136TH AVE APT 155",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986845970",
            "telephone_number": "512-906-8685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E 19TH ST STE 500",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986633385",
            "telephone_number": "360-313-6465"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1330 NE 136th Ave Apt 155",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986845970",
            "country_code": "US",
            "telephone_number": "512-906-8685",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCANALLY",
        "first_name": "KENDALL",
        "name_prefix": "Ms.",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-14",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "WA",
            "license": "61529334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; 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.