Jennevieve Moon Anderson, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA60813804 Issued in WA

Practice address

21 Bellwether Way Ste 101
Bellingham, WA 98225-2961

Phone

(360) 502-7548

Fax

(360) 797-9647

NPI assigned

Aug 22, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Summit Sports Chiropractic LLC

  • Chiropractor
  • Bellingham, WA
  • NPI 1538823869
  NPD
• Ohana Pacific

  • Massage Therapist
  • Bellingham, WA
  • NPI 1083075014
  NPD (past)
• Ohana Pacific, Inc.

  • Chiropractor
  • Bellingham, WA
  • NPI 1225226608
  NPD (past)

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

{
    "created_epoch": "1534896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1639650336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 BELLWETHER WAY STE 101",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982252961",
            "telephone_number": "360-502-7548",
            "fax_number": "360-797-9647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 BELLWETHER WAY STE 101",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982252961",
            "telephone_number": "360-502-7548",
            "fax_number": "360-797-9647"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2701 Northwest Ave. (Ohana Pacific, Inc.)",
            "address_purpose": "LOCATION",
            "city": "Bellingham",
            "state": "WA",
            "postal_code": "98225",
            "country_code": "US",
            "telephone_number": "360-715-8722",
            "fax_number": "866-568-1992",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JENNEVIEVE",
        "middle_name": "MOON",
        "name_prefix": "Ms.",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-22",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60813804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David W Anderson, LMHC
• Elizabeth Ann Anderson
• Freja Anderson
• Gregory J Anderson
• James Lucas Anderson, DD
• Karla M Anderson, BS
• Kate Anderson, MFTA
• Katherine L Anderson, P. A.
• Kayla Janae Anderson, DPT
• Kiana Lee Anderson

• Massage Therapist in Bellingham, WA
• Providers in Bellingham, WA by specialty
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; 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.