Individual provider Active NPI

Jolien R Paddock, LMP

  • Massage Therapist
  • Enumclaw, WA
National Provider Identifier
1750549465
Registry record updated May 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00007843 Issued in WA
Practice address
1724 Cole St
Suite #6
Enumclaw, WA 98022-3554
Phone
(253) 569-3625
NPI assigned
May 29, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2008

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 MA00007843 WA Primary

Addresses

Primary practice location

1724 Cole St
Suite #6
Enumclaw, WA 98022-3554

Mailing address

39110 244TH Ave SE
Enumclaw, WA 98022-8858
Phone (253) 569-3625

Other names 1

  • Ms. Jodi R Paddock Other name

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
MA00007843WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1212019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212019200000",
    "number": "1750549465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39110 244TH AVE SE",
            "city": "ENUMCLAW",
            "state": "WA",
            "postal_code": "980228858",
            "telephone_number": "253-569-3625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1724 COLE ST",
            "address_2": "SUITE #6",
            "city": "ENUMCLAW",
            "state": "WA",
            "postal_code": "980223554",
            "telephone_number": "253-569-3625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADDOCK",
        "first_name": "JOLIEN",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-29",
        "last_updated": "2008-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00007843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JODI",
            "last_name": "PADDOCK",
            "middle_name": "R",
            "prefix": "MS.",
            "credential": "LMP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Enumclaw, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2008; 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.