Lyrlene KQM Javellana, LMP

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA00017760 Issued in WA

Practice address

1042 W James St
Suite No 101
Kent, WA 98032-4606

Phone

(253) 852-3770

Fax

(253) 852-3913

NPI assigned

Mar 15, 2007

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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Flynn Chiropractic

  • Chiropractor
  • Kent, WA
  • NPI 1053167411
  NPD (past)

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700910320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28704 235TH AVE SE",
            "city": "MAPLE VALLEY",
            "state": "WA",
            "postal_code": "980383315",
            "telephone_number": "206-799-9029",
            "fax_number": "253-852-3913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1042 W JAMES ST",
            "address_2": "SUITE NO 101",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980324606",
            "telephone_number": "253-852-3770",
            "fax_number": "253-852-3913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAVELLANA",
        "first_name": "LYRLENE",
        "middle_name": "KQM",
        "name_prefix": "Mrs.",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00017760",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPLOYER ID NUMBER",
            "identifier": "91792822",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE - MASSAGE",
            "identifier": "MA00017760",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I PROVIDER NUMBER",
            "identifier": "0192232",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Victoria A Jaramillo, DPT
• Ronald Scott Jarvis
• Gurman Singh Jaswal, DMD
• Harpreet Singh Jaswal, DDS
• Hafsa Javed
• Jay D. Deiglmeier DDS. PS
• Teri Jeffries
• Benjamin Jelinek
• Pete Jelinek
• Safira Vasya Jendriza

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.