Healthcare Provider Details

I. General information

NPI: 1790620599
Provider Name (Legal Business Name): JADE SWIFT LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 W WINNIE LN STE 102
CARSON CITY NV
89703-2154
US

IV. Provider business mailing address

1011 S ROOP ST APT 1106
CARSON CITY NV
89701-5369
US

V. Phone/Fax

Practice location:
  • Phone: 775-671-4118
  • Fax:
Mailing address:
  • Phone: 775-671-4118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberNVMT.13442
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: