Individual provider Active NPI

Taylor Jacklin, LMP

  • Massage Therapist
  • Spokane Valley, WA
National Provider Identifier
1588021794
Registry record updated Jan 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60546884 Issued in WA
Practice address
303 S University Rd
Spokane Valley, WA 99206-5227
Phone
(509) 922-4458
Fax
(509) 922-8234
NPI assigned
Jan 19, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2016

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 MA60546884 WA Primary

Addresses

Primary practice location

303 S University Rd
Spokane Valley, WA 99206-5227

Mailing address

14208 E Hopper Rd
Spokane, WA 99217-8500
Phone (208) 230-8765

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
MA60546884WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
University Chiropractic Services, Inc. PastSince Apr 15, 1991 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1453161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453161600000",
    "number": "1588021794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14208 E HOPPER RD",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992178500",
            "telephone_number": "208-230-8765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 S UNIVERSITY RD",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992065227",
            "telephone_number": "509-922-4458",
            "fax_number": "509-922-8234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKLIN",
        "first_name": "TAYLOR",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-19",
        "last_updated": "2016-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60546884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane Valley, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2016; 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.