Individual provider Active NPI

Jennifer Klunder, LMT

  • Massage Therapist
  • Mount Vernon, WA
National Provider Identifier
1710114426
Registry record updated Jun 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00008450 Issued in WA
Practice address
410 Commercial St
Suite 3
Mount Vernon, WA 98273-5537
Phone
(360) 661-3022
Fax
(360) 854-7786
NPI assigned
Jun 19, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2009

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 MA00008450 WA Primary

Addresses

Primary practice location

410 Commercial St
Suite 3
Mount Vernon, WA 98273-5537

Mailing address

13240 Buchanan LN
Mount Vernon, WA 98273-8589
Phone (360) 661-3022

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
MA00008450WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1245369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245369600000",
    "number": "1710114426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13240 BUCHANAN LN",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982738589",
            "telephone_number": "360-661-3022",
            "fax_number": "360-854-7786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 COMMERCIAL ST",
            "address_2": "SUITE 3",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982735537",
            "telephone_number": "360-661-3022",
            "fax_number": "360-854-7786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUNDER",
        "first_name": "JENNIFER",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-19",
        "last_updated": "2009-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00008450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2009; 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.