Active NPI
Jason Dwane Grose, LMP
- Massage Therapist
- Bellevue, WA
National Provider Identifier
1144505421
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA60133008
- Practice address
- 1940 116TH Ave NE,
Suite 100
Bellevue, WA 98004 - Phone
- (425) 590-9208
- Fax
- (425) 968-1466
- NPI assigned
- Oct 18, 2011
- Sex
- Male
- 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 | MA60133008 | WA | Primary |
Addresses
Primary practice location
1940 116TH Ave NE,
Suite 100
Bellevue, WA 98004
Mailing address
1940 116TH Ave NE,
Suite 100
Bellevue, WA 98004
Phone (425) 590-9208
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 |
|---|---|---|---|
| MA60133008 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549929600000",
"number": "1144505421",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1940 116TH AVE NE,",
"address_2": "SUITE 100",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "98004",
"telephone_number": "425-590-9208",
"fax_number": "425-968-1466"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1940 116TH AVE NE,",
"address_2": "SUITE 100",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "98004",
"telephone_number": "425-590-9208",
"fax_number": "425-968-1466"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROSE",
"first_name": "JASON",
"middle_name": "DWANE",
"credential": "LMP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-10-18",
"last_updated": "2019-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA60133008",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bellevue, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 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.