Individual provider Active NPI

Trina G Jennings, LMP

  • Mechanotherapist
  • Redmond, WA
National Provider Identifier
1780820654
Registry record updated Jul 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
MechanotherapistTaxonomy code 172M00000X
License
MA00019642 Issued in WA
Practice address
11435 Avondale Rd NE
Redmond, WA 98052-2801
Phone
(425) 647-8831
Fax
(206) 420-5310
NPI assigned
Dec 26, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mechanotherapist 172M00000X MA00019642 WA Primary

Addresses

Primary practice location

11435 Avondale Rd NE
Redmond, WA 98052-2801

Mailing address

14331 124TH Ave NE Apt C31
Kirkland, WA 98034-1480
Phone (425) 647-8831

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
MA00019642WAMDMechanotherapist

NPI Registry JSON

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

{
    "created_epoch": "1230249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311379200000",
    "number": "1780820654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14331 124TH AVE NE APT C31",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980341480",
            "telephone_number": "425-647-8831",
            "fax_number": "206-420-5310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11435 AVONDALE RD NE",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980522801",
            "telephone_number": "425-647-8831",
            "fax_number": "206-420-5310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "TRINA",
        "middle_name": "G",
        "name_prefix": "Mrs.",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-26",
        "last_updated": "2011-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172M00000X",
            "taxonomy_group": "",
            "desc": "Mechanotherapist",
            "state": "WA",
            "license": "MA00019642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2011; 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.