Provider Demographics
NPI:1063563609
Name:HUGHES, KRESHENDA ELLAINE (LMT)
Entity type:Individual
Prefix:
First Name:KRESHENDA
Middle Name:ELLAINE
Last Name:HUGHES
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:KRESHENDA
Other - Middle Name:ELLIANE
Other - Last Name:KEITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:6013 ROOSEVELT WAY NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-6610
Mailing Address - Country:US
Mailing Address - Phone:206-734-2990
Mailing Address - Fax:206-525-9355
Practice Address - Street 1:6013 ROOSEVELT WAY NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-6610
Practice Address - Country:US
Practice Address - Phone:206-734-2990
Practice Address - Fax:206-420-0319
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00017598225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist