Jessica Ann Malyevac

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA60977601 Issued in WA

Practice address

15 S Grady Way Ste LL25
Renton, WA 98057-3218

Phone

(425) 228-5217

NPI assigned

Aug 12, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Century Massage & Bodywork, Inc

  • Specialist
  • Renton, WA
  • NPI 1205004777
  NPD (past)

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

{
    "created_epoch": "1565568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565568000000",
    "number": "1457907818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22606 114TH AVE SE",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980312647",
            "telephone_number": "253-508-7542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 S GRADY WAY STE LL25",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980573218",
            "telephone_number": "425-228-5217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALYEVAC",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-12",
        "last_updated": "2019-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60977601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON STATE DEPARTMENT OF HEALTH",
            "identifier": "MA60977601",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Malchodi
• Laura Maldonado Montoya
• Madison Maley, L.M.P.
• Nisreen Malik, BDS, DDS, MFD, MBA
• Sumaya Malin
• Mandy J. Louis, D.M.D., P.L.L.C.
• Avdeep Kaur Mangat, DO
• Alexandra Noelle Manness, BSN, RN
• Andrew Steven Manolides, M.D.
• Sujatha Manthini, M.D

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.

Verify at the official NPI Registry.