Active NPI
Jennifer Prout
- Massage Therapist
- Everett, WA
National Provider Identifier
1396107702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA60622258
- Practice address
- 201B E Beech St
Everett, WA 98203-4340 - Phone
- (425) 353-9612
- NPI assigned
- Mar 24, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA60622258 | WA | Primary |
Addresses
Primary practice location
201B E Beech St
Everett, WA 98203-4340
Mailing address
201B E Beech St
Everett, WA 98203-4340
Phone (425) 353-9612
Other names 1
- Jennifer Michelle Walby
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 |
|---|---|---|---|
| MA60622258 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458777600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458777600000",
"number": "1396107702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201B E BEECH ST",
"city": "EVERETT",
"state": "WA",
"postal_code": "982034340",
"telephone_number": "425-353-9612"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201B E BEECH ST",
"city": "EVERETT",
"state": "WA",
"postal_code": "982034340",
"telephone_number": "425-353-9612"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROUT",
"first_name": "JENNIFER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-24",
"last_updated": "2016-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA60622258",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "WALBY",
"middle_name": "MICHELLE",
"credential": "LMP",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Everett, WA
- Proliance Surgeons Inc., P.S.
- Proliance Surgeons, Inc., P.S.
- Proliance Surgeons, Inc., P.S.
- Proliance Surgeons, Inc., P.S.
- Proliance Surgeons, Inc., P.S.
- Providence Health & Services
- Providence Health & Services - Wa
- Providence Health & Services - Wa
- Providence Health & Services - Wa
- Providence Health & Services - Wa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.