Provider Demographics
NPI:1912383084
Name:MASSAGE BY KAYLYN
Entity Type:Organization
Organization Name:MASSAGE BY KAYLYN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMP
Authorized Official - Prefix:MS
Authorized Official - First Name:KAYLYN
Authorized Official - Middle Name:MARIEL
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-948-6861
Mailing Address - Street 1:1730 S DAYTON PL
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99337-4828
Mailing Address - Country:US
Mailing Address - Phone:509-948-6861
Mailing Address - Fax:
Practice Address - Street 1:636 JADWIN AVE STE E
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-4255
Practice Address - Country:US
Practice Address - Phone:509-948-6861
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-30
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty