Active NPI
Jessica Ann Jackson, L.M.T
- Massage Therapist
- Clackamas, OR
National Provider Identifier
1033370101
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 9341
- Practice address
- 13131 SE 125TH Ave
Clackamas, OR 97015-9324 - Phone
- (503) 756-9494
- NPI assigned
- Jun 22, 2008
- Sex
- Female
- 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 | 9341 | OR | Primary |
Addresses
Primary practice location
13131 SE 125TH Ave
Clackamas, OR 97015-9324
Mailing address
10728 SE Sunnyside Rd
Clackamas, OR 97015-9781
Phone (503) 756-9494
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 |
|---|---|---|---|
| 9341 | OR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1278892800000",
"number": "1033370101",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10728 SE SUNNYSIDE RD",
"city": "CLACKAMAS",
"state": "OR",
"postal_code": "970159781",
"telephone_number": "503-756-9494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13131 SE 125TH AVE",
"city": "CLACKAMAS",
"state": "OR",
"postal_code": "970159324",
"telephone_number": "503-756-9494"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "JESSICA",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "L.M.T",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-06-22",
"last_updated": "2010-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "9341",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clackamas, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.