MEDICARE: JADE DEIDERS LMP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	MA00022112	WA
2	225700000X	Massage Therapist	12874	OR

General Provider Information

NPI Number	:	1689091340
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JADE DEIDERS LMP

Provider Business Mailing Address
First Line	:	2482 HIGHWAY 141
Second Line	:
City	:	TROUT LAKE
State	:	WA
Zip	:	98650-9703
Country	:	US
Telephone Number	:	541-490-2933
Fax Number	:

Provider Business Practice Location Address
First Line	:	302 W STEUBEN ST
Second Line	:	#7
City	:	BINGEN
State	:	WA
Zip	:	98605-0834
Country	:	US
Telephone Number	:	541-490-2933
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2014
Last Update Date	:	03/19/2014

Similar Medicare Providers

1821159914 — JOHN D LLOYD MA
Practice Location Address:

1000 W STEUBEN ST
BINGEN, WA
98605-9175

Practice Phone: 509-493-1143
Practice Fax: 877-644-1937

1013040419 — PAUL E HOLMAN DC
Practice Location Address:

1000 W STEUBEN ST
BINGEN, WA
98605

Practice Phone: 509-493-2882
Practice Fax: 509-493-2882

1437275153 — BACK WORKS UNLTD INC
Practice Location Address:

1000 W STEUBEN ST
BINGEN, WA
98605

Practice Phone: 509-493-2882
Practice Fax: 509-493-2882

1538488390 — ROBERTA MARINA GRANT LMT
Practice Location Address:

208 WEST STEUBEN
BINGEN, WA
98605-0000

Practice Phone: 541-490-9794
Practice Fax:

1063724953 — COMPASSIONATE COUNSELING
Practice Location Address:

1000 W STEUBEN
BINGEN, WA
98605

Practice Phone: 509-493-1143
Practice Fax:

1063967677 — CITRINE ACUPUNCTURE & HERBAL CLINIC LLC
Practice Location Address:

1000 W STEUBEN ST STE 2A
BINGEN, WA
98605-9175

Practice Phone: 509-281-3200
Practice Fax:

Directions to “ JADE DEIDERS LMP” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.