Individual provider Active NPI

Jean L Clough, LMP

  • Massage Therapist
  • Seattle, WA
National Provider Identifier
1992816458
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00006957 Issued in WA
Practice address
5355 Tallman Ave NW
Suite 215
Seattle, WA 98107
Phone
(206) 675-1740
Fax
(206) 675-1043
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 MA00006957 WA Primary

Addresses

Primary practice location

5355 Tallman Ave NW
Suite 215
Seattle, WA 98107

Mailing address

5355 Tallman Ave NW
Suite 215
Seattle, WA 98107
Phone (206) 675-1740

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
MA00006957WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1992816458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5355 TALLMAN AVE NW",
            "address_2": "SUITE 215",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98107",
            "telephone_number": "206-675-1740",
            "fax_number": "206-675-1043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5355 TALLMAN AVE NW",
            "address_2": "SUITE 215",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98107",
            "telephone_number": "206-675-1740",
            "fax_number": "206-675-1043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLOUGH",
        "first_name": "JEAN",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00006957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.