Provider Demographics
NPI:1083014245
Name:JAMES, KENA
Entity Type:Individual
Prefix:
First Name:KENA
Middle Name:
Last Name:JAMES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7932 35TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98126-3405
Mailing Address - Country:US
Mailing Address - Phone:503-277-3389
Mailing Address - Fax:
Practice Address - Street 1:2200 6TH AVE
Practice Address - Street 2:SUITE #832
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98121-1896
Practice Address - Country:US
Practice Address - Phone:206-441-2505
Practice Address - Fax:206-441-2508
Is Sole Proprietor?:No
Enumeration Date:2014-08-25
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR16990225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist