Kimberly Bianco-Smith

Individual provider Active NPI Massage Therapist · Snoqualmie, WA

NPI 1902206196 · NPPES record last updated Aug 26, 2014

Key facts

NPI
1902206196
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
MA00012293 (WA)
Practice address
35230 SE Ridge St Unit C
Snoqualmie, WA 98065-9035
Phone
(425) 777-0405
NPI assigned
Aug 26, 2014
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
MA00012293WAMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA00012293 WA Yes

Addresses

Primary practice location

35230 SE Ridge St Unit C
Snoqualmie, WA 98065-9035

Mailing address

35230 SE Ridge St Unit C
Snoqualmie, WA 98065-9035
Phone (425) 777-0405

Other providers in Snoqualmie, WA

All providers in Snoqualmie, WA · Massage Therapist in Washington

Sources for this page

Verify at the official NPI Registry.