NPIMap

Individual provider Active NPI

Jade Emily Peschek, LMP

  • Massage Therapist
  • Enumclaw, WA
National Provider Identifier
1033383146
Registry record updated Apr 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00012079 Issued in WA
Practice address
2520 Warner Ave
Enumclaw, WA 98022-2004
Phone
(253) 229-3603
NPI assigned
Apr 18, 2008
Last updated
Apr 18, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA00012079 WA Primary

Addresses

Primary practice location

2520 Warner Ave
Enumclaw, WA 98022-2004

Mailing address

PO Box 757
Enumclaw, WA 98022-0757
Phone (253) 229-3603

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bonney Lake Clinical Massage LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1208476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208476800000",
    "number": "1033383146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 757",
            "city": "ENUMCLAW",
            "state": "WA",
            "postal_code": "980220757",
            "telephone_number": "253-229-3603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 WARNER AVE",
            "city": "ENUMCLAW",
            "state": "WA",
            "postal_code": "980222004",
            "telephone_number": "253-229-3603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PESCHEK",
        "first_name": "JADE",
        "middle_name": "EMILY",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-18",
        "last_updated": "2008-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00012079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enumclaw, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2008; 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.