Jessica Rae Crofoot, LMP

Primary specialty

SpecialistTaxonomy code 174400000X

License

MA00022713 Issued in WA

Practice address

12737 Bel Red Rd Ste 210
Bellevue, WA 98005-2697

Phone

(425) 885-5581

Fax

(877) 271-2511

NPI assigned

Jan 24, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Mrs. Jessica Rae Sohl Former name

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": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456963200000",
    "number": "1629123997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12737 BEL RED RD STE 210",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980052697",
            "telephone_number": "425-829-1205",
            "fax_number": "877-271-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12737 BEL RED RD STE 210",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980052697",
            "telephone_number": "425-885-5581",
            "fax_number": "877-271-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROFOOT",
        "first_name": "JESSICA",
        "middle_name": "RAE",
        "name_prefix": "Ms.",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2016-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA00022713",
            "primary": true
        },
        {
            "code": "173C00000X",
            "taxonomy_group": "",
            "desc": "Reflexologist",
            "state": "WA",
            "license": "RF 60480656",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "SOHL",
            "middle_name": "RAE",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Margaret A Cristofalo, PHD, MSW, LICSW
• Gretchen Louise Crittenden, MD
• Angela J Crivello, DPT
• Danielle Marie Crivello, MS, RD, CD
• Lauren Anne Crockett, LMHC, MS, NCC
• Hilary Jane Croft, PT
• Kathleen Cassaundra Diane Crofton
• Madeline Crofts, MS, RDN
• Brian Daniel Crosier, P.T.
• Thassanee Cross, LMP

• Specialist in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.