Individual provider Active NPI

Theresa Fjermedal, LMP

  • Massage Therapist
  • Seattle, WA
National Provider Identifier
1245652536
Registry record updated Oct 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA 60142822 Issued in WA
Practice address
6204 8TH Ave NW
Seattle, WA 98107-2270
Phone
(206) 784-3494
NPI assigned
Jan 6, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 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 MA 60142822 WA Primary

Addresses

Primary practice location

6204 8TH Ave NW
Seattle, WA 98107-2270

Mailing address

3102 NW 85TH St
Seattle, WA 98117-3929
Phone (206) 713-7083

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
MA 60142822WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1388966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412121600000",
    "number": "1245652536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3102 NW 85TH ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981173929",
            "telephone_number": "206-713-7083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6204 8TH AVE NW",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981072270",
            "telephone_number": "206-784-3494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FJERMEDAL",
        "first_name": "THERESA",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-06",
        "last_updated": "2014-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA 60142822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.