Healthcare Provider Details

I. General information

NPI: 1912860446
Provider Name (Legal Business Name): KELLY MORGAN LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2025
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5355 TALLMAN AVE NW STE 214-217
SEATTLE WA
98107-3935
US

IV. Provider business mailing address

8305 31ST AVE NW
SEATTLE WA
98117-3947
US

V. Phone/Fax

Practice location:
  • Phone: 206-675-1740
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMASS.MA.70063724
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: