Provider Demographics
NPI:1285446682
Name:CURTIS, KISS'SHONNA (LMT)
Entity type:Individual
Prefix:
First Name:KISS'SHONNA
Middle Name:
Last Name:CURTIS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23817 109TH STREET CT E
Mailing Address - Street 2:
Mailing Address - City:BUCKLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98321-8701
Mailing Address - Country:US
Mailing Address - Phone:253-209-8535
Mailing Address - Fax:253-862-6002
Practice Address - Street 1:16515 MERIDIAN E STE 103B
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98375-6252
Practice Address - Country:US
Practice Address - Phone:253-209-8535
Practice Address - Fax:253-862-6002
Is Sole Proprietor?:No
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA61606183225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist