Active NPI
Jalene Smith, LMP
- Massage Therapist
- Chehalis, WA
National Provider Identifier
1679971568
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA00015967
- Practice address
- 2530 NE Kresky Ave Ste B
Chehalis, WA 98532-2406 - Phone
- (360) 996-4778
- Fax
- (360) 996-4783
- NPI assigned
- Dec 9, 2014
- 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 | MA00015967 | WA | Primary |
Addresses
Primary practice location
2530 NE Kresky Ave Ste B
Chehalis, WA 98532-2406
Mailing address
8942 Colony LN SE
Tenino, WA 98589-9426
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0162228 | Other | WA | DEPARTMENT OF LABOR AND INDUSTRIES |
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 |
|---|---|---|---|
| MA00015967 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1418083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1418083200000",
"number": "1679971568",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8942 COLONY LN SE",
"city": "TENINO",
"state": "WA",
"postal_code": "985899426"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2530 NE KRESKY AVE STE B",
"city": "CHEHALIS",
"state": "WA",
"postal_code": "985322406",
"telephone_number": "360-996-4778",
"fax_number": "360-996-4783"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "JALENE",
"credential": "LMP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-12-09",
"last_updated": "2014-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA00015967",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPARTMENT OF LABOR AND INDUSTRIES",
"identifier": "0162228",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chehalis, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.