Individual provider Active NPI

Jennifer Tanguay

  • Massage Therapist
  • Washougal, WA
National Provider Identifier
1346749785
Registry record updated Feb 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60829239 Issued in WA
Practice address
3307 Evergreen Way Ste 601
Washougal, WA 98671-2062
Phone
(360) 835-9911
NPI assigned
Feb 11, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2018

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 MA60829239 WA Primary

Addresses

Primary practice location

3307 Evergreen Way Ste 601
Washougal, WA 98671-2062

Mailing address

33111 SE Wood Dr
Washougal, WA 98671-9582

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
MA60829239WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pure Wellness Chiropractic Washougal PLLC PastSince Sep 29, 2024 Accepting new patients
Michael a. Dornbusch, DC, PS Massage Therapist PastSince Apr 27, 2009 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1518307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518307200000",
    "number": "1346749785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33111 SE WOOD DR",
            "city": "WASHOUGAL",
            "state": "WA",
            "postal_code": "986719582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3307 EVERGREEN WAY STE 601",
            "city": "WASHOUGAL",
            "state": "WA",
            "postal_code": "986712062",
            "telephone_number": "360-835-9911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANGUAY",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-11",
        "last_updated": "2018-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60829239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washougal, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2018; 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.