Provider Demographics
NPI:1063697373
Name:BALL, KATY GRACE (LMT)
Entity type:Individual
Prefix:
First Name:KATY
Middle Name:GRACE
Last Name:BALL
Suffix:
Gender:
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13027 25TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-4240
Mailing Address - Country:US
Mailing Address - Phone:206-979-0509
Mailing Address - Fax:
Practice Address - Street 1:12304 32ND AVE NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-5506
Practice Address - Country:US
Practice Address - Phone:206-979-0509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-05
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00018819225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist