Jessica Baca, LMP

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA00025110 Issued in WA

Practice address

27116 167TH PL SE
114
Covington, WA 98042-7341

Phone

(253) 630-6614

Fax

(253) 630-6624

NPI assigned

Mar 14, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Body Works Massage Clinic

  • Medical Specialty Clinic/Center
  • Covington, WA
  • NPI 1518129329
  NPD (past)
• Marquis Massage Group, LLC

  • Massage Therapist
  • Covington, WA
  • NPI 1235274374
  NPD (past)

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

{
    "created_epoch": "1205452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205452800000",
    "number": "1326219619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12932 SE KENT KANGLEY RD",
            "address_2": "438",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980307940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27116 167TH PL SE",
            "address_2": "114",
            "city": "COVINGTON",
            "state": "WA",
            "postal_code": "980427341",
            "telephone_number": "253-630-6614",
            "fax_number": "253-630-6624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACA",
        "first_name": "JESSICA",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-14",
        "last_updated": "2008-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00025110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Derek Baril III

• All providers in Covington, WA
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2008; 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.