Individual provider Active NPI

Alexis Ann Juergens

  • Massage Therapist
  • Richland, WA
National Provider Identifier
1467764985
Registry record updated Jul 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00014821 Issued in WA
Practice address
636 Jadwin Ave
Suite # E
Richland, WA 99352-4255
Phone
(509) 392-1642
NPI assigned
Jul 13, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA00014821 WA Primary

Addresses

Primary practice location

636 Jadwin Ave
Suite # E
Richland, WA 99352-4255

Mailing address

2021 Davison Ave
Richland, WA 99354-2014
Phone (509) 392-1642

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

LicenseStateTypeSpecialty
MA00014821WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1278979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278979200000",
    "number": "1467764985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 DAVISON AVE",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993542014",
            "telephone_number": "509-392-1642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 JADWIN AVE",
            "address_2": "SUITE # E",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993524255",
            "telephone_number": "509-392-1642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUERGENS",
        "first_name": "ALEXIS",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-13",
        "last_updated": "2010-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00014821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.