KIMBERLY RENE WYATT (NPI# 1538492301) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538492301 |
| Entity Type | Individual |
| Full Name | KIMBERLY RENE WYATT |
| Credential | LMT |
| Practice Address |
3229 Broadway St Ste G North Bend OR 97459-2203 |
| Practice Telephone | 5417517979 |
| Practice Fax Number | 5417517877 |
| Mailing Telephone | 5417517979 |
| Mailing Fax Number | 5417517877 |
| Enumeration Date | 2009-09-11 |
| Last Update Date | 2009-09-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | 10760 | OR | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982223947 | Kimberly Lashawn Wyatt | Licensed Practical Nurse | 180 Autumn Chapel Way, Rochester, NY 14624-5304 | 2020-04-10 |
| 1326024902 | Kimberly Sue Wyatt | Internal Medicine | 509 Se Riverside Dr Ste 303, Stuart, FL 34994-2579 | 2005-12-15 |
| 1770116394 | Kimberly Wyatt | Social Worker | 2600 Center St Ne, Salem, OR 97301-2669 | 2020-02-21 |
| 1245719079 | Kimberly Wyatt | Case Manager/Care Coordinator | 10 Tsienneto Rd, Derry, NH 03038-1505 | 2018-08-13 |
| 1194269019 | Kimberly Saphaire-dawn Wyatt | Counselor | 209 Milwaukee St, Mount Vernon, WA 98273 | 2016-12-12 |
| 1336579622 | Kimberly Wyatt | Chiropractor | 1670 Mckendree Church Rd, Suite 400 B, Lawrenceville, GA 30043-4107 | 2013-11-22 |
| 1538490297 | Kimberly Anne Wyatt | Physician Assistant | 707 Hollybrook Dr, Longview, TX 75605-2410 | 2010-01-20 |
| Street Address |
3229 BROADWAY ST STE G |
| City | NORTH BEND |
| State | OR |
| Zip Code | 97459-2203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568002749 | Ya-chi Claire Chang | Nurse Practitioner | 1229 1890 Waite St #1, North Bend, OR 97459 | 2020-01-15 |
| 1629573977 | Heather M Coates | Counselor | 400 Virginia Ave Ste 100, North Bend, OR 97459 | 2018-03-28 |
| 1205257219 | Melissa Sperry | Health Educator | 510 Lockhart Street, North Bend, OR 97459 | 2013-12-17 |
| 1265862627 | Elizabeth Sylvester | Counselor | 1592 Monroe Street, North Bend, OR 97459 | 2013-11-22 |
| 1124370291 | Brian Noble Thompson | Pharmacist | 3411 Broadway St., North Bend, OR 97459 | 2012-10-12 |
| 1295081230 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 3411 Broadway St, North Bend, OR 97459 | 2012-07-27 |
| 1366728370 | Melissa Jean Kovach | Occupational Therapy Assistant | 3959 Sheridan Ave., North Bend, OR 97459 | 2011-10-24 |
| 1295045052 | Mary Kay Weikel | Massage Therapist | 3229 Broadway St Suite G Serenity Therapy Center, North Bend, OR 97459 | 2010-10-14 |
| 1902080013 | Anthony Eugene Baldacci | Registered Nurse | 1836 Meade Street, North Bend, OR 97459 | 2007-12-26 |
| 1952595340 | Inland Point Senior Estates Jv LLC | Clinic/Center | 2265 Inland Drive, North Bend, OR 97459 | 2007-08-29 |
| Find all providers in zip 97459 | ||||
| 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 |
|---|---|---|---|---|
| 1962032805 | Tammy Kaye Freire | Massage Therapist | 777 Virginia Ave, North Bend, OR 97459-3427 | 2020-01-20 |
| 1386098358 | Ruth Sacket | Massage Therapist | 3229 Broadway Ave Ste G, North Bend, OR 97459-2203 | 2016-04-15 |
| 1922482249 | Rest, Relax, Recover Therapeutic Massage Center | Massage Therapist | 1834 Mcpherson St, Suite B, North Bend, OR 97459-3414 | 2015-07-16 |
| 1760866289 | Brittany Cooper | Massage Therapist | 3436 Broadway Ave, North Bend, OR 97459-1202 | 2015-07-14 |
| 1982098513 | Robin Kay | Massage Therapist | 47301 Se 159th St, North Bend, WA 98045-8650 | 2015-03-20 |
| 1467726331 | Elena Kathaleen Overland | Massage Therapist | 16105 Cedar Falls Rd Se, North Bend, WA 98045-9006 | 2012-02-23 |
| 1083981500 | Sarah Michelle Stoll | Massage Therapist | 42902 Se 173rd St, North Bend, WA 98045-9304 | 2011-11-29 |
| 1013200807 | Therapeutic Health LLC | Massage Therapist | 230 W 3rd Street, North Bend, WA 98045 | 2011-05-26 |
| 1922399500 | Nicole Renee Femling | Massage Therapist | 111 W North Bend Way, North Bend, WA 98045 | 2011-04-29 |
| 1295045052 | Mary Kay Weikel | Massage Therapist | 3229 Broadway St Suite G Serenity Therapy Center, North Bend, OR 97459 | 2010-10-14 |
| Find all providers in NORTH BEND | ||||
| City | NORTH BEND |
| Zip Code | 97459 |
Please comment or provide details below to improve the information on KIMBERLY RENE WYATT.
| 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.