Healthcare Provider Details

I. General information

NPI: 1689581555
Provider Name (Legal Business Name): SARAH KUKES MA 60208487
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

706 ALDER ST
EDMONDS WA
98020-3416
US

IV. Provider business mailing address

706 ALDER ST
EDMONDS WA
98020-3416
US

V. Phone/Fax

Practice location:
  • Phone: 425-563-3781
  • Fax:
Mailing address:
  • Phone: 425-563-3781
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA60208487
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: