Provider Demographics
NPI:1962200212
Name:KNEAD MASSAGE THERAPY, PLLC
Entity type:Organization
Organization Name:KNEAD MASSAGE THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MASSAGE THERAPIST, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELLY JO
Authorized Official - Middle Name:
Authorized Official - Last Name:WEBSTER
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:253-426-3763
Mailing Address - Street 1:4610 S 73RD ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98409-1417
Mailing Address - Country:US
Mailing Address - Phone:253-426-3763
Mailing Address - Fax:
Practice Address - Street 1:208 WILKES ST
Practice Address - Street 2:
Practice Address - City:STEILACOOM
Practice Address - State:WA
Practice Address - Zip Code:98388-2122
Practice Address - Country:US
Practice Address - Phone:253-426-3763
Practice Address - Fax:253-260-1613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty