Healthcare Provider Details

I. General information

NPI: 1932348810
Provider Name (Legal Business Name): CHRISTINE ANN PROKAY MSESS, BA, RA, LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2009
Last Update Date: 02/06/2025
Certification Date: 02/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 MAIN ST
JULIAETTA ID
83535
US

IV. Provider business mailing address

15919 BUTTERCUP LN
JULIAETTA ID
83535-6020
US

V. Phone/Fax

Practice location:
  • Phone: 253-241-3183
  • Fax:
Mailing address:
  • Phone: 253-241-3183
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMA60064542
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code226300000X
TaxonomyKinesiotherapist
License NumberMAS-4903
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: