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MR. KENNETH MARK WALLACE JR. LMP
NPI 1346548708
Massage Therapist in Mercer Island, WA

Active since March 09, 2011
4004 89TH AVE SE, MERCER ISLAND, WA 98040(206) 396-8452 Get Directions Write a Review

NPPES record last updated: March 29, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Kenneth Mark Wallace Jr. Lmp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. KENNETH MARK WALLACE JR. LMP (NPI 1346548708) is an individual massage therapist in Mercer Island, Washington, licensed in Washington (MA60197801) and active in the NPI registry since March 2011.

NPPES Registry Identity

NPI1346548708
Entity TypeIndividualMale
Primary Taxonomy225700000X
Provider Legal NameMR. KENNETH MARK WALLACE JR.Credential: LMP
Location Address4004 89TH AVE SEMercer Island, WA 98040-4102
Mailing Address4004 89th Ave SeMercer Island, WA 98040-4102 · (206) 396-8452
Phone(206) 396-8452
Sole ProprietorYes
Enumeration DateMarch 9, 2011
Last NPPES UpdateMarch 29, 2011
✔ NPI 1346548708 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225700000X
License✔ Licensed in WA · MA60197801
Definition
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.
4004 89TH AVE SE, Mercer Island, WA 98040
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kenneth Wallace's NPI number?

The NPI number for Kenneth Wallace is 1346548708. It was assigned to this individual provider in the NPPES registry on March 9, 2011.

Where is Kenneth Wallace located?

Kenneth Wallace practices at 4004 89th Ave SE, Mercer Island, WA 98040. The listed phone number is (206) 396-8452.

What is Kenneth Wallace's specialty?

The primary specialty registered for this NPI is Massage Therapist with taxonomy code 225700000X.

When was this NPI record last updated?

The NPPES record for Kenneth Wallace was last updated on March 29, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.