Jeremiah Lyles Johnson, LMP

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA60177126 Issued in WA

Practice address

7514 46TH PL NE
Marysville, WA 98270-8913

Phone

(253) 677-2799

NPI assigned

Dec 3, 2010

Last updated

Dec 3, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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": "1291334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291334400000",
    "number": "1467754986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7514 46TH PL NE",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982708913",
            "telephone_number": "253-677-2799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7514 46TH PL NE",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982708913",
            "telephone_number": "253-677-2799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JEREMIAH",
        "middle_name": "LYLES",
        "name_prefix": "Mr.",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-12-03",
        "last_updated": "2010-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60177126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Sungsu Jo, PHARM.D.
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• John D Hixson DDS PS
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• Alaine Marie Johnson, SUDPT
• Juanita Johnson
• Sara C Jones, MS
• Brianna Joyce, DC
• Julia McGary DDS Inc PS (Cedar Family Dentistry)
• Husseini Juma

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.

Verify at the official NPI Registry.