Active NPI
Claire Dierksen, LMT
- Massage Therapist
- Snohomish, WA
National Provider Identifier
1043082662
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA61492151
- Practice address
- 302 Maple Ave
Snohomish, WA 98290-2526 - Phone
- (360) 568-3319
- NPI assigned
- Oct 26, 2023
- Sex
- Female
- Sole proprietor
- No
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 | MA61492151 | WA | Primary |
Addresses
Primary practice location
302 Maple Ave
Snohomish, WA 98290-2526
Mailing address
33342 NE 118TH PL
Carnation, WA 98014-7113
Phone (909) 477-7059
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
- Credentials
- Master of Theology
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA61492151 | WA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Heart Spring Health LLC | Past | Accepting new patients | |
| The Rewilding Practice LLC | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Acupuncturist
- Portland, OR
- NPI 1891672903
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1698278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698278400000",
"number": "1043082662",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33342 NE 118TH PL",
"city": "CARNATION",
"state": "WA",
"postal_code": "980147113",
"telephone_number": "909-477-7059"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "302 MAPLE AVE",
"city": "SNOHOMISH",
"state": "WA",
"postal_code": "982902526",
"telephone_number": "360-568-3319"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIERKSEN",
"first_name": "CLAIRE",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-10-26",
"last_updated": "2023-10-26",
"certification_date": "2023-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA61492151",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Snohomish, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.