Jacobe James Blake, LMP

Individual provider Active NPI Massage Therapist · Sequim, WA

NPI 1396429338 · NPPES record last updated Jun 12, 2023

Key facts

NPI
1396429338
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
MA61367040 (WA)
Practice address
532 N 5TH Ave
Sequim, WA 98382-3185
Phone
(360) 683-7911
Fax
(360) 683-3981
NPI assigned
Jun 12, 2023
Sex
Male
Sole proprietor
No

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
MA61367040WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sorensen Chiropractic LLC Current
since Jun 18, 2023
Accepting new patients

Locations

532 N 5th Ave
Sequim, WA 98382
Phone (360) 683-7911

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA61367040 WA Yes

Addresses

Primary practice location

532 N 5TH Ave
Sequim, WA 98382-3185

Mailing address

532 N 5TH Ave
Sequim, WA 98382-3185
Phone (360) 683-7911

Other providers in Sequim, WA

All providers in Sequim, WA · Massage Therapist in Washington

Sources for this page

Verify at the official NPI Registry.