Individual provider Active NPI

Jennifer Soames, LMP

  • Massage Therapist
  • Maple Valley, WA
National Provider Identifier
1376688747
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00022636 Issued in WA
Practice address
23925 225TH Way SE
Suite B
Maple Valley, WA 98038-5233
Phone
(425) 433-0760
Fax
(425) 433-0733
NPI assigned
Feb 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 MA00022636 WA Primary

Addresses

Primary practice location

23925 225TH Way SE
Suite B
Maple Valley, WA 98038-5233

Mailing address

12932 SE Kent Kangley Rd
#438
Kent, WA 98030-7940
Phone (425) 392-1814

Other identifiers 1

IdentifierTypeStateIssuer
0215154OtherWADEPT OF L&I

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
MA00022636WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376688747",
    "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",
            "telephone_number": "425-392-1814",
            "fax_number": "425-392-1813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23925 225TH WAY SE",
            "address_2": "SUITE B",
            "city": "MAPLE VALLEY",
            "state": "WA",
            "postal_code": "980385233",
            "telephone_number": "425-433-0760",
            "fax_number": "425-433-0733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOAMES",
        "first_name": "JENNIFER",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00022636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF L&I",
            "identifier": "0215154",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Valley, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.