Kenneth De la Torre-Riley, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA61447554 Issued in WA

Practice address

1627 S 312TH St
Federal Way, WA 98003-4915

Phone

(253) 839-9330

Fax

(253) 839-9330

NPI assigned

May 24, 2023

Last updated

May 24, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Theology

State licenses

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

{
    "created_epoch": "1684886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1942992144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2306 177TH ST E",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984454222",
            "telephone_number": "252-665-4396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1627 S 312TH ST",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980034915",
            "telephone_number": "253-839-9330",
            "fax_number": "253-839-9330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9701 S Tacoma Way Ste 106",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "WA",
            "postal_code": "984994490",
            "country_code": "US",
            "telephone_number": "253-588-8340",
            "fax_number": "253-588-8340",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12811 SE 38th St",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "WA",
            "postal_code": "980061326",
            "country_code": "US",
            "telephone_number": "425-644-7582",
            "fax_number": "425-644-7582",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE LA TORRE-RILEY",
        "first_name": "KENNETH",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-24",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA61447554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in Federal Way, WA
• Providers in Federal Way, WA by specialty
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; 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.