MR. DEVAN KELSO (NPI# 1467807420) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467807420 |
| Entity Type | Individual |
| Full Name | MR. DEVAN KELSO |
| Credential | LMP |
| Practice Address |
12911 Se Kent Kangley Rd Kent WA 98030-7939 |
| Mailing Address |
Po Box 1451 Auburn WA 98071-1451 |
| Practice Telephone | 2532770029 |
| Mailing Telephone | 2085531824 |
| Enumeration Date | 2016-04-27 |
| Last Update Date | 2016-04-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | MA 60369798 | WA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | AMTA | 1296672 | 01 |
| Street Address |
12911 SE KENT KANGLEY RD |
| City | KENT |
| State | WA |
| Zip Code | 98030-7939 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174944938 | Tia Partridge | Massage Therapist | 12911 Se Kent Kangley Rd, Kent, WA 98030-7939 | 2013-12-20 |
| 1326463381 | Vivian Clinical Day Spa | Health Maintenance Organization | 12911 Se Kent Kangley Rd, Kent, WA 98030-7939 | 2014-02-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871193193 | Sarah V Swan | Occupational Therapist | 12033 Se 265th St, Kent, WA 98030 | 2020-10-27 |
| 1346889250 | Kaylee Meilahn | Nurse Practitioner | 219 State Ave. N, Suite 220, Kent, WA 98030 | 2019-12-26 |
| 1508417429 | Pamela Stefansky | Technician | 25927 119th Ct Se, Kent, WA 98030 | 2019-09-23 |
| 1144703885 | Healthpoint | Clinic/Center | 219 State Ave N, Ste 100, Kent, WA 98030 | 2018-09-10 |
| 1932681921 | Johana Sanchez-vidales | Massage Therapist | 24837 104th Ave Se #100, Kent, WA 98030 | 2018-09-05 |
| 1265925309 | Linda Tomkins | Chiropractor | 12901 Se Kent-kangley Rd, Kent, WA 98030 | 2018-06-13 |
| 1952809543 | Sarah Rose Collins | Massage Therapist | 13003 Se Kent Kangley Rd Ste 110, Kent, WA 98030 | 2018-01-29 |
| 1942726815 | Alexandra B Zigmont | Physical Therapist | 12926 Se Kent Kangley Road, Kent, WA 98030 | 2017-08-22 |
| 1659801256 | Mitra Lal Dhital | Counselor | 3639 Mlk Jr Way S Seattle, Seattle, WA 98030 | 2017-06-15 |
| 1952838658 | Elizabeth Burson | Registered Nurse | 25742 104th Avenue Se, Kent, WA 98030 | 2017-05-12 |
| Find all providers in zip 98030 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609421635 | Sabrina Michelle Jones | Massage Therapist | 25022 104th Ave Se Ste E, Kent, WA 98030-2822 | 2019-08-06 |
| 1124686621 | Shannon Strong | Massage Therapist | 64 Maple St Ste 1, Kent, CT 06757-1721 | 2019-05-31 |
| 1184180135 | Olesya Tkachyshyn | Massage Therapist | 11738 Se 264th St, Kent, WA 98030-8467 | 2019-02-14 |
| 1033683529 | William Kelly Blackburn | Massage Therapist | 24620 Russell Rd Apt D102, Kent, WA 98032-4745 | 2019-01-17 |
| 1811460306 | Alla Yakobchuk | Massage Therapist | 11108 Se 264th Pl, Kent, WA 98030-9032 | 2019-01-07 |
| 1821560798 | Jeanmarie Meier | Massage Therapist | 12505 Se 275th Pl, Kent, WA 98030-8523 | 2018-12-17 |
| 1932681921 | Johana Sanchez-vidales | Massage Therapist | 24837 104th Ave Se #100, Kent, WA 98030 | 2018-09-05 |
| 1952809543 | Sarah Rose Collins | Massage Therapist | 13003 Se Kent Kangley Rd Ste 110, Kent, WA 98030 | 2018-01-29 |
| 1295233328 | Tommy Eugene Sauget | Massage Therapist | 29020 188th Ave Se, Kent, WA 98042-9223 | 2018-01-23 |
| 1710408968 | Celyna Dayanara Easley | Massage Therapist | 27020 Pacific Hwy S Ste B, Kent, WA 98032-6951 | 2017-06-28 |
| Find all providers in KENT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.