Jeffery B Wang, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA61158410 Issued in WA

Practice address

4525 3Rd Ave SE Ste 200
Lacey, WA 98503-1010

Phone

(503) 360-8989

NPI assigned

Jun 12, 2021

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1623456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626307200000",
    "number": "1417525924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1708 10TH AVE SE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985011817",
            "telephone_number": "503-360-8989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4525 3RD AVE SE STE 200",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985031010",
            "telephone_number": "503-360-8989"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5600 Pacific Ave SE",
            "address_purpose": "LOCATION",
            "city": "Lacey",
            "state": "WA",
            "postal_code": "985031258",
            "country_code": "US",
            "telephone_number": "503-360-8989",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANG",
        "first_name": "JEFFERY",
        "middle_name": "B",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-12",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA61158410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walmart Inc.
• Walmart Inc.
• Matthew Waltrip
• George Christian Wang, PHARMACIST
• Hui Wang, MD
• Nancy Wang, DDS
• Jordan Ward
• Warren Physician Services
• Sarah Jane Warren
• David Michael Warwick, D.C.

• Massage Therapist in Lacey, WA
• Providers in Lacey, WA by specialty
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; 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.