Provider Demographics
NPI:1649523853
Name:MCGUIRE, KYLEE (LMT)
Entity type:Individual
Prefix:
First Name:KYLEE
Middle Name:
Last Name:MCGUIRE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:KYLEE
Other - Middle Name:
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:21316 SE 274TH PL
Mailing Address - Street 2:
Mailing Address - City:MAPLE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98038-3275
Mailing Address - Country:US
Mailing Address - Phone:206-225-7480
Mailing Address - Fax:
Practice Address - Street 1:15610 KENT KANGLEY RD
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:WA
Practice Address - Zip Code:98042-4416
Practice Address - Country:US
Practice Address - Phone:253-638-2424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-25
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60252267225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist