Jade Deiders, LMP
Individual provider Active NPI Massage Therapist · Bingen, WA
NPI 1689091340 · NPPES record last updated Mar 19, 2014
Key facts
- NPI
- 1689091340
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- MA00022112 (WA)
- Practice address
- 302 W Steuben St
#7
Bingen, WA 98605-0834 - Phone
- (541) 490-2933
- NPI assigned
- Mar 19, 2014
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12874 | OR | MD | Massage Therapist |
| MA00022112 | WA | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA00022112 | WA | Yes |
| Massage Therapist | 225700000X | 12874 | OR |
Addresses
Primary practice location
302 W Steuben St
#7
Bingen, WA 98605-0834
Mailing address
2482 Highway 141
Trout Lake, WA 98650-9703
Phone (541) 490-2933
Other providers in Bingen, WA
- Molly Basta
- Chambers Family Chiropractic, PLLC.
- Ian Chambers
- Citrine Acupuncture & Herbal Clinic LLC
- Compassionate Counseling
- Roberta Marina Grant
- Paul E Holman
- Cory Jubitz
- Stephanie Marie Kozloski
- John D Lloyd
All providers in Bingen, WA · Massage Therapist in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 19, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.