Individual provider Active NPI

Jeffrey Nadeau, LMP

  • Massage Therapist
  • Issaquah, WA
National Provider Identifier
1205988995
Registry record updated Aug 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00008629 Issued in WA
Practice address
1505 NW Gilman Blvd Ste 3
Issaquah, WA 98027-5398
Phone
(206) 920-0987
NPI assigned
Jan 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2014

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 MA00008629 WA Primary

Addresses

Primary practice location

1505 NW Gilman Blvd Ste 3
Issaquah, WA 98027-5398

Mailing address

1420 NW Gilman Blvd # 2245
Issaquah, WA 98027-5394
Phone (206) 920-0987

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
MA00008629WAMDMassage Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409097600000",
    "number": "1205988995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 NW GILMAN BLVD # 2245",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980275394",
            "telephone_number": "206-920-0987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 NW GILMAN BLVD STE 3",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980275398",
            "telephone_number": "206-920-0987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NADEAU",
        "first_name": "JEFFREY",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2014-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00008629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Issaquah, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2014; 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.