Jessica Kaari Dretke, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MAS-3848 Issued in ID

Practice address

2151 W Hayden Ave
Hayden, ID 83835-7414

Phone

(208) 215-4269

NPI assigned

Aug 17, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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": "1534464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1528548633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24800 N OLD HIGHWAY 95",
            "city": "ATHOL",
            "state": "ID",
            "postal_code": "838018225",
            "telephone_number": "120-821-5426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2151 W HAYDEN AVE",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838357414",
            "telephone_number": "208-215-4269"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6147 W Maine St",
            "address_purpose": "LOCATION",
            "city": "Spirit Lake",
            "state": "ID",
            "postal_code": "838690149",
            "country_code": "US",
            "telephone_number": "208-215-4269",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DRETKE",
        "first_name": "JESSICA",
        "middle_name": "KAARI",
        "name_prefix": "Mrs.",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-17",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60877114",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "ID",
            "license": "MAS-3848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Hayden, ID
• Massage Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; 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.