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General NPI Number Information
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NPI Number | 1962200212
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Entity Type | Organization
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Legal Business Name | KNEAD MASSAGE THERAPY, PLLC
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Dates
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Enumeration Date | 03/04/2025
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Last Update Date | 05/19/2025
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Provider Practice Location Address
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Address Line | 208 WILKES ST
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City | STEILACOOM
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State | WA
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Zip | 98388-2122
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Country | US
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Telephone | 253-426-3763
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Fax | 253-260-1613
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Provider Business Mailing Address
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Address Line | 4610 S 73RD ST
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City | TACOMA
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State | WA
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Zip | 98409-1417
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Country | US
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Telephone | 253-426-3763
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Fax |
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Authorized Official
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Title or Position | LICENSED MASSAGE THERAPIST, OWNER
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Name | KELLY JO WEBSTER
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Credential | LMT
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Telephone | 253-426-3763
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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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