Healthcare Provider Details

I. General information

NPI: 1124936745
Provider Name (Legal Business Name): KB MASSAGE STUDIO, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2749 152ND AVE NE BLDG 4H
REDMOND WA
98052-5555
US

IV. Provider business mailing address

27028 SE 170TH ST
ISSAQUAH WA
98027-8268
US

V. Phone/Fax

Practice location:
  • Phone: 253-722-3306
  • Fax:
Mailing address:
  • Phone: 253-722-3306
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: KELLI MCKEOWN
Title or Position: OWNER/MASSAGE THERAPIST
Credential: LMT
Phone: 253-722-3306