Individual provider Active NPI

Jonathan David Leifheit, LMP

  • Massage Therapist
  • Vancouver, WA
National Provider Identifier
1477877280
Registry record updated Mar 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60133357 Issued in WA
Practice address
15001 NE 47TH St
Vancouver, WA 98682-6372
Phone
(360) 433-8951
NPI assigned
Mar 23, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 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 MA60133357 WA Primary

Addresses

Primary practice location

15001 NE 47TH St
Vancouver, WA 98682-6372

Mailing address

15001 NE 47TH St
Vancouver, WA 98682-6372
Phone (360) 433-8951

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
MA60133357WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1269302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269302400000",
    "number": "1477877280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15001 NE 47TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986826372",
            "telephone_number": "360-433-8951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15001 NE 47TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986826372",
            "telephone_number": "360-433-8951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIFHEIT",
        "first_name": "JONATHAN",
        "middle_name": "DAVID",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-23",
        "last_updated": "2010-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60133357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 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.