MR. KELLY MCKEON (NPI# 1699269837) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699269837 |
| Entity Type | Individual |
| Full Name | MR. KELLY MCKEON |
| Credential | LMT |
| Practice Address |
8650 Martin Way E Ste 207 Lacey WA 98516-6610 |
| Mailing Address |
400 Cooper Point Rd Sw #27 #12228 Olympia WA 98502 |
| Practice Telephone | 3609514504 |
| Practice Fax Number | 8778487757 |
| Mailing Telephone | 3609514504 |
| Mailing Fax Number | 8778487757 |
| Enumeration Date | 2018-06-20 |
| Last Update Date | 2020-07-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | MA60855605 | WA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184243305 | Kelly Mckeon | Student in an Organized Health Care Education/Training Program | 110 Irving St Nw Dept Of, Washington, DC 20010-3017 | 2020-04-09 |
| 1457823064 | Kelly J Mckeon | Physical Therapist | 790 N Highway 67 St, Florissant, MO 63031-5108 | 2018-12-20 |
| Street Address |
8650 MARTIN WAY E STE 207 |
| City | LACEY |
| State | WA |
| Zip Code | 98516-6610 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396707246 | David Michael Warwick | Chiropractor | 8650 Martin Way E Ste 207, Lacey, WA 98516-6610 | 2006-04-05 |
| 1386123156 | Lizabeth Aldrich | Massage Therapist | 8650 Martin Way E Ste 207, Lacey, WA 98516 | 2018-08-12 |
| 1558852889 | Jennifer Virivong | Massage Therapist | 8650 Martin Way E Ste 207, Lacey, WA 98516-6610 | 2018-05-22 |
| 1336643840 | Lasondra Fuller | Massage Therapist | 8650 Martin Way E Ste 207, Lacey, WA 98516-6610 | 2018-03-20 |
| 1619478070 | Francisca Marie Dreckman | Massage Therapist | 8650 Martin Way E Ste 207, Lacey, WA 98516-6610 | 2018-02-21 |
| 1457746679 | Bridget Mixon | Massage Therapist | 8650 Martin Way E Ste 207, Lacey, WA 98516-6610 | 2015-04-03 |
| 1013311422 | David M. Warwick Dc Pllc | Chiropractor | 8650 Martin Way E Ste 207, Lacey, WA 98516-6610 | 2014-10-14 |
| 1558794495 | Valerie Thompson | Massage Therapist | 8650 Martin Way E Ste 207, Lacey, WA 98516-6610 | 2013-08-14 |
| 1447592597 | Amber Christine Quinton | Massage Therapist | 8650 Martin Way E Ste 207, Lacey, WA 98516-6610 | 2013-03-26 |
| 1033497243 | Marisa Alyse Rivera | Massage Therapist | 8650 Martin Way E Ste 207, Lacey, WA 98516-6610 | 2011-07-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730744210 | Michael Oropeza | Behavioral Analyst | 8282 28th Court Northeast, Suite A, Lacey, WA 98516 | 2019-05-09 |
| 1902361330 | Amanda Jessica Mae Allen | Behavioral Analyst | Basics Nw LLC, 8282 28th Ct Ne Suite A, Lacey, WA 98516 | 2019-02-11 |
| 1619459393 | Kayla-renee Williams | Behavioral Analyst | Basics Nw LLC 8282 28th Ct Ne, Suite A, Lacey, WA 98516 | 2018-08-30 |
| 1174004303 | Julie Ann Lisowski | Massage Therapist | 3532 Cuddy Ln Ne, Lacey, WA 98516 | 2018-08-26 |
| 1740700145 | Joseph Brandon Kimmel | Denturist | 5032 Beverly Dr Ne, Olympia, WA 98516 | 2017-06-27 |
| 1649649880 | Katie Cole | Behavioral Analyst | 8282 28th Ct Ne, Suite A, Basics Nw, LLC, Lacey, WA 98516 | 2015-09-17 |
| 1306234166 | Reza Tahernia | Dentist | 8050 Freedon Lane Ne, Suite C, Lacey, WA 98516 | 2015-01-02 |
| 1770997603 | Qualified Surgical Services Pllc | Surgery | 3697 Cameron Dr Ne, Lacey, WA 98516 | 2014-06-18 |
| 1184048688 | Stephanie Renee Hjortedal | Specialist/Technologist | 8750 Tallon Lane Ne., Lacey, WA 98516 | 2014-02-05 |
| 1295169811 | Teasha Corrado | Behavioral Analyst | 8282 28th Court Ne, Suite A, Lacey, WA 98516 | 2013-08-30 |
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| 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 |
|---|---|---|---|---|
| 1154922250 | Wanju S Kellams | Massage Therapist | 677 Woodland Square Loop Se # A-8, Lacey, WA 98503-1000 | 2020-11-04 |
| 1508475435 | Christina Lufkin | Massage Therapist | 1607 Dogwood St Se, Lacey, WA 98503-2742 | 2020-07-27 |
| 1447801253 | Hawk P Mason | Massage Therapist | 1445 Galaxy Dr Ne Ste 301, Lacey, WA 98516-4754 | 2019-09-23 |
| 1174004303 | Julie Ann Lisowski | Massage Therapist | 3532 Cuddy Ln Ne, Lacey, WA 98516 | 2018-08-26 |
| 1366931057 | Megan M Cronn | Massage Therapist | 6525 3rd Way Se, Lacey, WA 98503-7932 | 2018-05-08 |
| 1659895449 | Kayla Lord | Massage Therapist | 5750 Ruddell Rd Se Ste B, Lacey, WA 98503-5100 | 2017-08-02 |
| 1518493055 | Nearing Total Health, Pllc | Massage Therapist | 4520 Intelco Loop Se Bldg 3, Lacey, WA 98503-6008 | 2017-05-03 |
| 1720539281 | Keveyonna Davis | Massage Therapist | 677 Woodland Square Loop Se Ste A8, Lacey, WA 98503-1000 | 2016-10-19 |
| 1710432620 | Owen Wise | Massage Therapist | 8730 Tallon Ln Ne Ste 104, Lacey, WA 98516-6609 | 2016-08-20 |
| 1376993576 | Stacie Lynn Edwards | Massage Therapist | 4520 Intelco Loop Se, Ste 3a, Lacey, WA 98503-6008 | 2016-06-17 |
| Find all providers in LACEY | ||||
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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.