Active NPI
Jim Locklear, MASSAGE THERAPIST
- Massage Therapist
- Burien, WA
National Provider Identifier
1013555846
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA00015110
- Practice address
- 612 SW 152ND St
Burien, WA 98166-2213 - Phone
- (206) 244-1466
- NPI assigned
- Dec 11, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA00015110 | WA | Primary |
Addresses
Primary practice location
612 SW 152ND St
Burien, WA 98166-2213
Mailing address
15607 18TH Ave SW
Burien, WA 98166-2701
Phone (206) 354-8560
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA00015110 | WA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Integrum Healthcare LLC | Single Specialty | Current | Accepting new patients |
| Moss Chiropractic PC | Single Specialty | Past | Accepting new patients |
Locations
612 SW 152nd St
Burien, WA 98166
Phone (206) 244-1466
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1576022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576022400000",
"number": "1013555846",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15607 18TH AVE SW",
"city": "BURIEN",
"state": "WA",
"postal_code": "981662701",
"telephone_number": "206-354-8560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "612 SW 152ND ST",
"city": "BURIEN",
"state": "WA",
"postal_code": "981662213",
"telephone_number": "206-244-1466"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOCKLEAR",
"first_name": "JIM",
"credential": "MASSAGE THERAPIST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-12-11",
"last_updated": "2019-12-11",
"certification_date": "2019-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA00015110",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burien, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.