Individual provider Active NPI

Jaycub Robert Lemaster

  • Massage Therapist
  • Snohomish, WA
National Provider Identifier
1598484339
Registry record updated Aug 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA61294478 Issued in WA
Practice address
1101 Avenue D Ste D205
Snohomish, WA 98290-2004
Phone
(360) 217-8467
Fax
(360) 217-7092
NPI assigned
Aug 24, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2022

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 MA61294478 WA Primary

Addresses

Primary practice location

1101 Avenue D Ste D205
Snohomish, WA 98290-2004

Mailing address

1101 Avenue D Ste D205
Snohomish, WA 98290-2004
Phone (360) 217-8467

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
MA61294478WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Classic Massage Clinic, PLLC Massage Therapist CurrentSince Dec 3, 2023 Accepting new patients

Locations

1101 Avenue D
Ste D205
Snohomish, WA 98290
Phone (360) 217-8467

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": "1661299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661299200000",
    "number": "1598484339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 AVENUE D STE D205",
            "city": "SNOHOMISH",
            "state": "WA",
            "postal_code": "982902004",
            "telephone_number": "360-217-8467",
            "fax_number": "360-217-7092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 AVENUE D STE D205",
            "city": "SNOHOMISH",
            "state": "WA",
            "postal_code": "982902004",
            "telephone_number": "360-217-8467",
            "fax_number": "360-217-7092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEMASTER",
        "first_name": "JAYCUB",
        "middle_name": "ROBERT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-24",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA61294478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Snohomish, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2022; 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.