Jermaine Laurence Peake, LMP

Primary specialty

MechanotherapistTaxonomy code 172M00000X

License

MA60139525 Issued in WA

Practice address

15619 NE 1St Cir
Vancouver, WA 98684-3349

Phone

(360) 840-4197

NPI assigned

Apr 28, 2010

Last updated

Apr 28, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1272412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272412800000",
    "number": "1023335130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15619 NE 1ST CIR",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986843349",
            "telephone_number": "360-840-4197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15619 NE 1ST CIR",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986843349",
            "telephone_number": "360-840-4197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEAKE",
        "first_name": "JERMAINE",
        "middle_name": "LAURENCE",
        "name_prefix": "Mr.",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-28",
        "last_updated": "2010-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172M00000X",
            "taxonomy_group": "",
            "desc": "Mechanotherapist",
            "state": "WA",
            "license": "MA60139525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peacehealth Networks on Demand, LLC (ZoomCare - Grand Central)
• Peach Willow LLC (Peach Willow Spa)
• Paul Eugene Peachey, MD
• Peak Developmental Pediatrics, PLLC
• Stephanie Peak, AAC
• Tyler Jay Peake, PA-C
• Andrew Peaker, OT
• Pear Tree Counseling PLLC (Pear Tree Counseling)
• Pearl Family Medicine
• Evan Pearson

• Mechanotherapist in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Mechanotherapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.