Jean Ann Koncos, LMP

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

00019183 Issued in WA

Practice address

331 NE Lechner St
Camas, WA 98607-2445

Phone

(360) 635-3477

NPI assigned

Nov 17, 2010

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

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.

• At Vancouver Massage, LLC

  • Massage Therapist
  • Vancouver, WA
  • NPI 1164926374
  NPD (past) Authorized official

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

{
    "created_epoch": "1289952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289952000000",
    "number": "1982906343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17315 SE 2ND ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986839578",
            "telephone_number": "360-635-3477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 NE LECHNER ST",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986072445",
            "telephone_number": "360-635-3477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONCOS",
        "first_name": "JEAN",
        "middle_name": "ANN",
        "name_prefix": "Miss",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-17",
        "last_updated": "2010-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "00019183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Camas, WA
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2010; 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.