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General NPI Number Information
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NPI Number | 1124936745
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Entity Type | Organization
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Legal Business Name | KB MASSAGE STUDIO, PLLC
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Dates
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Enumeration Date | 09/01/2026
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Last Update Date | 09/01/2026
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Provider Practice Location Address
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Address Line | 2749 152ND AVE NE BLDG 4H
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City | REDMOND
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State | WA
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Zip | 98052-5555
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Country | US
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Telephone | 253-722-3306
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Fax |
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Provider Business Mailing Address
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Address Line | 27028 SE 170TH ST
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City | ISSAQUAH
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State | WA
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Zip | 98027-8268
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Country | US
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Telephone | 253-722-3306
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Fax |
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Authorized Official
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Title or Position | OWNER/MASSAGE THERAPIST
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Name | KELLI MCKEOWN
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Credential | LMT
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Telephone | 253-722-3306
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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