Amanda Marie Jean

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA60660506 Issued in WA

Practice address

319 S 11TH Ave
Yakima, WA 98902-3213

Phone

(509) 453-1420

Fax

(509) 453-1453

NPI assigned

Aug 6, 2016

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 1

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.

• DCS Therapeutic Massage

  • Massage Therapist
  • Yakima, WA
  • NPI 1912451071
  NPD (past)

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

{
    "created_epoch": "1470441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470441600000",
    "number": "1730633892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 S 11TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023213",
            "telephone_number": "509-453-1420",
            "fax_number": "509-453-1453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 S 11TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023213",
            "telephone_number": "509-453-1420",
            "fax_number": "509-453-1453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEAN",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-06",
        "last_updated": "2016-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60660506",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSAGE PRACTITIONER LICENSE",
            "identifier": "MA 60660506",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2016; 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.