Individual provider Active NPI

Kyla Ann-Marie Deisler, LMP

  • Massage Therapist
  • Port Orchard, WA
National Provider Identifier
1891239463
Registry record updated Dec 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
60619705 Issued in WA
Practice address
1707 Dekalb St
Port Orchard, WA 98366-4103
Phone
(360) 630-3485
NPI assigned
Dec 15, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2016

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 60619705 WA Primary

Addresses

Primary practice location

1707 Dekalb St
Port Orchard, WA 98366-4103

Mailing address

1707 Dekalb St
Port Orchard, WA 98366-4103
Phone (360) 630-3485

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
60619705WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1481760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481760000000",
    "number": "1891239463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1707 DEKALB ST",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983664103",
            "telephone_number": "360-630-3485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 DEKALB ST",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983664103",
            "telephone_number": "360-630-3485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEISLER",
        "first_name": "KYLA",
        "middle_name": "ANN-MARIE",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-15",
        "last_updated": "2016-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "60619705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orchard, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2016; 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.