Active NPI
Jennifer Anne Miller, LMT
- Massage Therapist
- Poulsbo, WA
National Provider Identifier
1053965798
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA60984676
- Practice address
- 18657 State Highway 305 NE Ste 4
Poulsbo, WA 98370-9184 - Phone
- (360) 779-7800
- Fax
- (360) 779-7060
- NPI assigned
- Jul 31, 2019
- 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 | MA60984676 | WA | Primary |
Addresses
Primary practice location
18657 State Highway 305 NE Ste 4
Poulsbo, WA 98370-9184
Mailing address
22305 Sunridge Way NE
Poulsbo, WA 98370-7789
Phone (360) 271-2771
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 |
|---|---|---|---|
| MA60984676 | WA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dewilde Chiropractic Inc | Massage Therapist | Current | Accepting new patients |
Locations
18657 State Highway 305 NE
Ste 4
Poulsbo, WA 98370
Phone (360) 779-7800
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1564531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564531200000",
"number": "1053965798",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22305 SUNRIDGE WAY NE",
"city": "POULSBO",
"state": "WA",
"postal_code": "983707789",
"telephone_number": "360-271-2771"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18657 STATE HIGHWAY 305 NE STE 4",
"city": "POULSBO",
"state": "WA",
"postal_code": "983709184",
"telephone_number": "360-779-7800",
"fax_number": "360-779-7060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "JENNIFER",
"middle_name": "ANNE",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-07-31",
"last_updated": "2019-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA60984676",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Poulsbo, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.