TRAVIS EDWARD JACKSON (NPI# 1174038368) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174038368 |
| Entity Type | Individual |
| Full Name | TRAVIS EDWARD JACKSON |
| Credential | LMT |
| Practice Address |
427 Sw 152nd St Unit C Burien WA 98166-2208 |
| Mailing Address |
21609 6th Ave S Normandy Park WA 98198-6114 |
| Practice Telephone | 2067870502 |
| Practice Fax Number | 2067870502 |
| Mailing Telephone | 2068780502 |
| Enumeration Date | 2017-12-10 |
| Last Update Date | 2017-12-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | MA60689794 | WA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528345212 | Travis C Jackson | Specialist/Technologist | 101 E 630 N Apt 20, Smithfield, UT 84335-9670 | 2011-11-08 |
| 1386288330 | Travis Aaron Jackson | Massage Therapist | 191 Charlotte St, Asheville, NC 28801-1989 | 2019-11-03 |
| 1720573678 | Travis Jackson | Case Manager/Care Coordinator | 124 Kimbrough Blvd Bldg Q124, Tallulah, LA 71282-4307 | 2018-06-23 |
| 1093063257 | Travis J Jackson | Counselor | 1550 Treat Ave, San Francisco, CA 94110-5234 | 2012-08-20 |
| 1194053322 | Travis Jackson | Social Worker | 2100 Comer Ave, Columbus, GA 31904-8725 | 2009-11-30 |
| 1043256126 | Travis Harold Jackson | Psychiatry & Neurology | 145 Kimel Park Dr, Suite 100, Winston-salem, NC 27103-6983 | 2006-06-20 |
| Street Address |
427 SW 152ND ST UNIT C |
| City | BURIEN |
| State | WA |
| Zip Code | 98166-2208 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508341488 | Robert James Woodland Sr. | Counselor | 1210 Sw 136th St., Burien, WA 98166 | 2018-09-26 |
| 1215467329 | Amy Elizabeth Castillo | Massage Therapist | 1204 Sw 168th St, Normandy Park, WA 98166 | 2017-06-13 |
| 1053856070 | Michael David Blackledge | Physical Therapist | 15811 Ambaum Blvd Sw Ste 140, Burien, WA 98166 | 2016-12-29 |
| 1114372232 | Maris Gibson | Massage Therapist | 801 S.w. 150thst, #110, Burien, WA 98166 | 2016-04-26 |
| 1649642992 | Navos | Community/Behavioral Health | 31408 28th Ave South, 1201 Sw 136th Street, Burien, WA 98166 | 2015-10-27 |
| 1154790798 | Han Nguyen | Chiropractor | 15811 Ambaum Blvd Sw Suite 110, Burien, WA 98166 | 2015-09-24 |
| 1497163778 | Maria Garvey-caruso | Physical Therapist | 1511 Ambaum Blvd South West, Suite 140, Burien, WA 98166 | 2014-07-30 |
| 1427495274 | Mohammed Nayeemuddin | Internal Medicine | 16259 Sylvester Rd Sw Ste 404, Burien, WA 98166 | 2013-06-03 |
| 1023362753 | Donna Shaman | Occupational Therapist | 15675 Ambaum Blvd, Burien, WA 98166 | 2012-11-02 |
| 1366707010 | Tracy C Saephanh | Pharmacy Technician | 14901 4th Ave Sw Ste 100, Burien, WA 98166 | 2012-07-09 |
| Find all providers in zip 98166 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114531977 | Lori Simmons | Massage Therapist | 13658 3rd Ave S, Burien, WA 98168-3410 | 2020-08-31 |
| 1235796418 | Sound Healing LLC | Massage Therapist | 125 S 156th St, Burien, WA 98148-1220 | 2019-05-23 |
| 1467979013 | Brian R Johnson Jr. | Massage Therapist | 275 Sw 160th St Ste 201, Burien, WA 98166-3003 | 2017-08-24 |
| 1114372232 | Maris Gibson | Massage Therapist | 801 S.w. 150thst, #110, Burien, WA 98166 | 2016-04-26 |
| 1952762387 | Blissful Knead LLC | Massage Therapist | 15513 Ambaum Blvd Sw, Ste 102, Burien, WA 98166-2424 | 2016-03-12 |
| 1760842272 | Jaime Marisa Van Doughty | Massage Therapist | 1015 Sw 150th St, Burien, WA 98166-1831 | 2016-02-25 |
| 1336506989 | Suzanne Mehl | Massage Therapist | 850 S 143rd Pl, Burien, WA 98168-3668 | 2016-01-26 |
| 1346615978 | Tawnesha R Hector | Massage Therapist | 15858 1st Ave South, Suite A104, Burien, WA 98148 | 2015-12-08 |
| 1881068393 | Sara Raved | Massage Therapist | 235 S 126th St, Burien, WA 98168-2610 | 2015-11-20 |
| 1710356316 | Laura Good | Massage Therapist | 1919 Sw Hillcrest Rd, Burien, WA 98166-3321 | 2015-09-24 |
| Find all providers in BURIEN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.