Individual provider Active NPI

Jennifer Marlene Tanner, L.M.P.

  • Massage Therapist
  • Wenatchee, WA
National Provider Identifier
1104011204
Registry record updated Nov 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00020951 Issued in WA
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

Updated by the provider on Nov 29, 2007

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 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

LicenseStateTypeSpecialty
MA00020951WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Decamp-Lewis Chiropractic Clinic, PLLC PastSince Oct 18, 1993 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.

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.

Verify at the official NPI Registry.