Individual provider Active NPI

Jessica Kylie Carter, LMT

  • Massage Therapist
  • Vancouver, WA
National Provider Identifier
1699249946
Registry record updated Jan 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
60796424 Issued in WA
Practice address
3021 NE 72ND Dr Ste 5
Vancouver, WA 98661-7300
Phone
(360) 869-0212
Fax
(360) 260-4849
NPI assigned
Jan 18, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2019

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 60796424 WA Primary

Addresses

Primary practice location

3021 NE 72ND Dr Ste 5
Vancouver, WA 98661-7300

Mailing address

15602 NE 78TH St
Vancouver, WA 98682-3510
Phone (720) 545-6242

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
60796424WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1547769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547769600000",
    "number": "1699249946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15602 NE 78TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986823510",
            "telephone_number": "720-545-6242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3021 NE 72ND DR STE 5",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986617300",
            "telephone_number": "360-869-0212",
            "fax_number": "360-260-4849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "JESSICA",
        "middle_name": "KYLIE",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-18",
        "last_updated": "2019-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "60796424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2019; 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.