Individual provider Active NPI

Jacqueline Auld Unzicker

  • Massage Therapist
  • Oak Harbor, WA
National Provider Identifier
1356856629
Registry record updated Dec 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60788607 Issued in WA
Practice address
840 SE Bayshore Dr Ste 101C
Oak Harbor, WA 98277-4062
Phone
(850) 293-5111
NPI assigned
Dec 8, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2017

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 MA60788607 WA Primary

Addresses

Primary practice location

840 SE Bayshore Dr Ste 101C
Oak Harbor, WA 98277-4062

Mailing address

1100 SW Harrier Cir Apt 4
Oak Harbor, WA 98277-2421
Phone (850) 293-5111

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
MA60788607WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1512691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512691200000",
    "number": "1356856629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 SW HARRIER CIR APT 4",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982772421",
            "telephone_number": "850-293-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 SE BAYSHORE DR STE 101C",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982774062",
            "telephone_number": "850-293-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNZICKER",
        "first_name": "JACQUELINE",
        "middle_name": "AULD",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-08",
        "last_updated": "2017-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60788607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Harbor, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2017; 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.