Jolene Marie Haferkorn, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA60788136 Issued in WA

Practice address

506 Grover St Ste 111
Lynden, WA 98264-1960

Phone

(425) 236-9088

NPI assigned

Nov 18, 2017

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1510963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540166400000",
    "number": "1821502485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 GROVER ST STE 111",
            "city": "LYNDEN",
            "state": "WA",
            "postal_code": "982641960",
            "telephone_number": "425-236-9088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 GROVER ST STE 111",
            "city": "LYNDEN",
            "state": "WA",
            "postal_code": "982641960",
            "telephone_number": "425-236-9088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "611 2nd St Ste F",
            "address_purpose": "LOCATION",
            "city": "Snohomish",
            "state": "WA",
            "postal_code": "982902934",
            "country_code": "US",
            "telephone_number": "425-236-9088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAFERKORN",
        "first_name": "JOLENE",
        "middle_name": "MARIE",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-18",
        "last_updated": "2018-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60788136",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON STATE DEPARTMENT OF HEALTH",
            "identifier": "MA60788136",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Catherine Green, LM, CPM
• Gregory J. Helgath, Inc. PS
• Michael R. Groen, D.D.S.
• Dawne M Grove, M.C. LMHC
• Lee Haak
• Doniel M Hagee, DPT
• Omar Tariq Hanjra
• Hansen Chiropractic, P.S.
• Kirstin Anita Hansen, MD
• Sara Joy Hardcastle

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2018; 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.