Active NPI
Jenn Moorman, LMP
- Massage Therapist
- Issaquah, WA
National Provider Identifier
1467864546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA00014835
- Practice address
- 670 NW Gilman Blvd
B2
Issaquah, WA 98027-2444 - Phone
- (425) 427-6562
- Fax
- (425) 390-2760
- NPI assigned
- May 23, 2014
- 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 | MA00014835 | WA | Primary |
Addresses
Primary practice location
670 NW Gilman Blvd
B2
Issaquah, WA 98027-2444
Mailing address
213 D St SE
Auburn, WA 98002-5527
Phone (425) 941-2954
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 |
|---|---|---|---|
| MA00014835 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400803200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1400803200000",
"number": "1467864546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "213 D ST SE",
"city": "AUBURN",
"state": "WA",
"postal_code": "980025527",
"telephone_number": "425-941-2954"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "670 NW GILMAN BLVD",
"address_2": "B2",
"city": "ISSAQUAH",
"state": "WA",
"postal_code": "980272444",
"telephone_number": "425-427-6562",
"fax_number": "425-390-2760"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORMAN",
"first_name": "JENN",
"credential": "LMP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-23",
"last_updated": "2014-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA00014835",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Issaquah, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.