Individual provider Active NPI

Jonathan Micheal Fairchild, L.M.P.

  • Massage Therapist
  • Tacoma, WA
National Provider Identifier
1639303068
Registry record updated May 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA60080892 Issued in WA
Practice address
3214 45TH Ave NE
Tacoma, WA 98422-2814
Phone
(253) 927-2897
NPI assigned
May 13, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2009

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 MA60080892 WA Primary

Addresses

Primary practice location

3214 45TH Ave NE
Tacoma, WA 98422-2814

Mailing address

3214 45TH Ave NE
Tacoma, WA 98422-2814
Phone (253) 927-2897

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
MA60080892WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1242172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242172800000",
    "number": "1639303068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3214 45TH AVE NE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984222814",
            "telephone_number": "253-927-2897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3214 45TH AVE NE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984222814",
            "telephone_number": "253-927-2897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRCHILD",
        "first_name": "JONATHAN",
        "middle_name": "MICHEAL",
        "credential": "L.M.P.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-13",
        "last_updated": "2009-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60080892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2009; 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.