IndividualActive
Jebediah Sides, LMT
NPI 1619738804 · Massage Therapist · Vancouver, WA
Provider details
- NPI number
- 1619738804
- Entity type
- Individual
- Primary specialty
- Massage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- LMT
- Sex
- Male
- Sole proprietor
- Yes
- License
- 61512969 (WA)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Profile Score
Established profile(62/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
14010 Ne 3rd Ct Bldg B
Vancouver, WA 98685-2928
Phone: (360) 949-0133
Fax: (360) 768-5110
Street-level locationGet directions
Mailing address
4414 Ne 115th St
Vancouver, WA 98686-4479
Additional practice locations (1)
- 11500 Ne 119th St Ste 104Vancouver, WA 98662-1643Phone: (360) 326-3396Fax: (360) 369-0015
Registry dates
- Enumerated
- 2024-01-16
- Last updated
- 2024-12-18
- Certified
- 2024-12-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.