Ehren Jackson, LMP

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA60371251 Issued in WA

Practice address

25 95TH Dr NE Ste 105
Lake Stevens, WA 98258-7976

Phone

(425) 334-9137

NPI assigned

Jun 24, 2016

Last updated

Dec 22, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ehren Martorella Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lake Stevens Massage Therapy, Inc.

  • Massage Therapist
  • Lake Stevens, WA
  • NPI 1821603291
  NPD
• Shanlee Stephens

  • Massage Therapist
  • Lake Stevens, WA
  • NPI 1609243740
  NPD (past)

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

{
    "created_epoch": "1466726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576972800000",
    "number": "1487005054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4214 84TH ST NE APT 5",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982703457",
            "telephone_number": "206-880-3177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 95TH DR NE STE 105",
            "city": "LAKE STEVENS",
            "state": "WA",
            "postal_code": "982587976",
            "telephone_number": "425-334-9137"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3933 Stone Way N",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981038017",
            "country_code": "US",
            "telephone_number": "206-588-0014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "EHREN",
        "name_prefix": "Ms.",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-24",
        "last_updated": "2019-12-22",
        "certification_date": "2019-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60371251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EHREN",
            "last_name": "MARTORELLA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• David Robert Hunter, DDS
• Carrie Lynn Hutchinson, LMP
• Carrie D Hyldahl, LMP, EOT
• Icure Physical Therapy LLC
• J Baldwin Global Enterprises, LLC (RN Consulting Services)
• Edward Jacobs, MD
• Angela Jakab-Miller, MA60592340
• Sheila Jalali, M.A.
• Alisa Faith James, DPT
• Alesha Jarmusch, D160083865

• Massage Therapist in Lake Stevens, WA
• Providers in Lake Stevens, 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 22, 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.