Active NPI
Jennifer Marlene Tanner, L.M.P.
- Massage Therapist
- Wenatchee, WA
National Provider Identifier
1104011204
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA00020951
- Practice address
- 610 N Mission St Ste 102
Wenatchee, WA 98801-2065 - Phone
- (509) 662-4711
- Fax
- (509) 662-2800
- NPI assigned
- Sep 11, 2007
- 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 | MA00020951 | WA | Primary |
Addresses
Primary practice location
610 N Mission St Ste 102
Wenatchee, WA 98801-2065
Mailing address
610 N Mission St Ste 102
Wenatchee, WA 98801-2065
Phone (509) 662-4711
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 |
|---|---|---|---|
| MA00020951 | WA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Decamp-Lewis Chiropractic Clinic, PLLC | 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 and National Provider Directory roles.
-
- Chiropractor
- Wenatchee, WA
- NPI 1235209479
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196294400000",
"number": "1104011204",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "610 N MISSION ST STE 102",
"city": "WENATCHEE",
"state": "WA",
"postal_code": "988012065",
"telephone_number": "509-662-4711",
"fax_number": "509-662-2800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "610 N MISSION ST STE 102",
"city": "WENATCHEE",
"state": "WA",
"postal_code": "988012065",
"telephone_number": "509-662-4711",
"fax_number": "509-662-2800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TANNER",
"first_name": "JENNIFER",
"middle_name": "MARLENE",
"credential": "L.M.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-11",
"last_updated": "2007-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA00020951",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wenatchee, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.