Active NPI
Jodi Green, LMP
- Massage Therapist
- Tacoma, WA
National Provider Identifier
1427350537
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA0015691
- Practice address
- 5015 Tacoma Mall Blvd # 102
Tacoma, WA 98409-7107 - Phone
- (253) 472-4400
- Fax
- (253) 472-1782
- NPI assigned
- Nov 22, 2010
- Last updated
- Nov 22, 2010
- 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 | MA0015691 | WA | Primary |
Addresses
Primary practice location
5015 Tacoma Mall Blvd # 102
Tacoma, WA 98409-7107
Mailing address
12310 26TH Ave E
Tacoma, WA 98445-5036
Phone (253) 537-7715
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 |
|---|---|---|---|
| MA0015691 | WA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| David Hendrickson D.C.PS | Past | Accepting new patients |
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": "1290384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1290384000000",
"number": "1427350537",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12310 26TH AVE E",
"city": "TACOMA",
"state": "WA",
"postal_code": "984455036",
"telephone_number": "253-537-7715"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5015 TACOMA MALL BLVD # 102",
"city": "TACOMA",
"state": "WA",
"postal_code": "984097107",
"telephone_number": "253-472-4400",
"fax_number": "253-472-1782"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "JODI",
"credential": "LMP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-11-22",
"last_updated": "2010-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA0015691",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.