MEDICARE: KANDYCE CRANDALL LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	MA60012593	WA

General Provider Information

NPI Number	:	1811152333
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KANDYCE CRANDALL LMT

Provider Business Mailing Address
First Line	:	PO BOX 1021
Second Line	:
City	:	SEABECK
State	:	WA
Zip	:	98380-1021
Country	:	US
Telephone Number	:	206-851-3425
Fax Number	:

Provider Business Practice Location Address
First Line	:	18158 W WINTER GREEN LN
Second Line	:
City	:	SEABECK
State	:	WA
Zip	:	98380-9458
Country	:	US
Telephone Number	:	206-851-3425
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/24/2008
Last Update Date	:	08/14/2025

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