Active NPI
Traci J Lemmon
- Massage Therapist
- Poulsbo, WA
National Provider Identifier
1679858773
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA60016417
- Practice address
- 19168 Jensen Way NE
Poulsbo, WA 98370 - Phone
- (360) 598-5500
- NPI assigned
- Oct 20, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA60016417 | WA | Primary |
Addresses
Primary practice location
19168 Jensen Way NE
Poulsbo, WA 98370
Mailing address
P.O. Box 154
Port Gamble, WA 98364
Phone (360) 779-9237
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
| License | State | Type | Specialty |
|---|---|---|---|
| MA60016417 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1319068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319068800000",
"number": "1679858773",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 154",
"city": "PORT GAMBLE",
"state": "WA",
"postal_code": "98364",
"telephone_number": "360-779-9237"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19168 JENSEN WAY NE",
"city": "POULSBO",
"state": "WA",
"postal_code": "98370",
"telephone_number": "360-598-5500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEMMON",
"first_name": "TRACI",
"middle_name": "J",
"name_prefix": "Miss",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-10-20",
"last_updated": "2011-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA60016417",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Poulsbo, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.