Active NPI
Jacque Larue, LMT
- Massage Therapist
- Ferndale, WA
National Provider Identifier
1386092120
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 60926499
- Practice address
- 2376 Main St Ste 1
Ferndale, WA 98248-8605 - Phone
- (360) 312-4656
- NPI assigned
- Jun 2, 2016
- Last updated
- Jul 24, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | NU | ||
| Massage Therapist | 225700000X | 60926499 | WA | Primary |
| Behavior Analyst | 103K00000X | NU |
Addresses
Primary practice location
2376 Main St Ste 1
Ferndale, WA 98248-8605
Mailing address
2377 Main St Unit D108
Ferndale, WA 98248-8852
Phone (360) 672-2121
Other practice location 1
324 NE Izett St
Apt. A1
Oak Harbor, WA 98277-2531
Phone (360) 672-2121
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
| License | State | Type | Specialty |
|---|---|---|---|
| 60926499 | WA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ferndale Chiropractic Clinic LLC | Single Specialty | Current | Accepting new patients |
Locations
2376 Main St
Ste 1
Ferndale, WA 98248
Phone (360) 312-4656
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563926400000",
"number": "1386092120",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2377 MAIN ST UNIT D108",
"city": "FERNDALE",
"state": "WA",
"postal_code": "982488852",
"telephone_number": "360-672-2121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2376 MAIN ST STE 1",
"city": "FERNDALE",
"state": "WA",
"postal_code": "982488605",
"telephone_number": "360-312-4656"
}
],
"practiceLocations": [
{
"address_1": "324 NE Izett St",
"address_2": "Apt. A1",
"address_purpose": "LOCATION",
"city": "Oak Harbor",
"state": "WA",
"postal_code": "982772531",
"country_code": "US",
"telephone_number": "360-672-2121",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LARUE",
"first_name": "JACQUE",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-06-02",
"last_updated": "2019-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "60926499",
"primary": true
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ferndale, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.