Jennifer Fagan, MA 60367097

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA 60367097 Issued in WA

Practice address

1800 Bickford Ave
Ste 201
Snohomish, WA 98290-1771

Phone

(425) 319-1123

Fax

(360) 863-2649

NPI assigned

Dec 8, 2013

Last updated

Dec 8, 2013By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Still Waters Massage Inc

  • Massage Therapist
  • Snohomish, WA
  • NPI 1861822652
  NPD (past)

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

{
    "created_epoch": "1386460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386460800000",
    "number": "1871924407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 BICKFORD AVE",
            "address_2": "STE 201",
            "city": "SNOHOMISH",
            "state": "WA",
            "postal_code": "982901771",
            "telephone_number": "425-319-1123",
            "fax_number": "360-863-2649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 BICKFORD AVE",
            "address_2": "STE 201",
            "city": "SNOHOMISH",
            "state": "WA",
            "postal_code": "982901771",
            "telephone_number": "425-319-1123",
            "fax_number": "360-863-2649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGAN",
        "first_name": "JENNIFER",
        "credential": "MA 60367097",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-08",
        "last_updated": "2013-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA 60367097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsey A Estes, B.A.
• Daniel Eun
• Vanna Evans
• Eve Rutherford DDS PLLC
• Excelled Healing LLC
• Laurie Michelle Farinella, ND
• Cynthia Nicole Farley, CCC, RN
• Danielle Fay, PHARM D
• Roland V. Feltner, M.D.
• First Responder Counseling and Consulting, PLLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2013; 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.