Organization Active NPI

Crossfunction Sports Massage, PLLC

  • Massage Therapist
  • Mill Creek, WA
National Provider Identifier
1316476112
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60410229 Issued in WA
Legal business name
CROSSFUNCTION SPORTS MASSAGE, PLLC
Practice address
805 164TH St SE Ste 100
Mill Creek, WA 98012-6316
Phone
(425) 418-8588
NPI assigned
Jun 6, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jenny Lynn Mapes, LMTNPI 1275949349
Title
Owner
Phone
(425) 595-3436

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225700000X MA60410229 WA Primary

Addresses

Primary practice location

805 164TH St SE Ste 100
Mill Creek, WA 98012-6316

Mailing address

805 164TH St SE Ste 100
Mill Creek, WA 98012-6316
Phone (425) 418-8588

Other identifiers 1

IdentifierTypeStateIssuer
1275949349OtherWAPERSONAL NPI NUMBER

National Provider Directory

National Provider Directory

Locations

16030 Bothell Hwy
Ste 140
Mill Creek, WA 98012
Phone (425) 338-9005

805 164th St SE
Ste 100
Mill Creek, WA 98012
Phone (425) 354-4296

16000 Bothell Everett Hwy
Unit 161
Mill Creek, WA 98012
Phone (425) 595-3436

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1496707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716940800000",
    "number": "1316476112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 164TH ST SE STE 100",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980126316",
            "telephone_number": "425-418-8588",
            "fax_number": "425-595-3436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 164TH ST SE STE 100",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980126316",
            "telephone_number": "425-418-8588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSFUNCTION SPORTS MASSAGE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-06",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A",
        "authorized_official_last_name": "MAPES",
        "authorized_official_first_name": "JENNY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-595-3436",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60410229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL NPI NUMBER",
            "identifier": "1275949349",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mill Creek, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2024; 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.