Healthcare Provider Details

I. General information

NPI: 1548172489
Provider Name (Legal Business Name): KIMBERLY KOLBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5600 14TH AVE NW STE 3
SEATTLE WA
98107-3723
US

IV. Provider business mailing address

4203 WILLIAMS AVE W
SEATTLE WA
98199-1543
US

V. Phone/Fax

Practice location:
  • Phone: 206-341-2848
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMASS.MA.70180654
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: