Leticia Ayala Maragh, ML

Key facts

NPI

1003022112

Entity type

Individual (NPI type 1)

Primary specialty

Family Medicine Physician 207Q00000X

License

MD60508339 (WA)

Practice address

7203 129TH Ave SE
Newcastle, WA 98056-1412

Phone

(425) 656-5406

Fax

(425) 656-5040

NPI assigned

May 15, 2007

Sex

Female

Sole proprietor

No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Valley Medical Group-Renton General Acute Care Hospital · Renton, WA · NPI 1619209574
  NPD FAMILY MEDICINE

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

Other names

• Leticia Ayala Former name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 1, 2014.

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412121600000",
    "number": "1003022112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34876",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241876",
            "telephone_number": "425-656-5412",
            "fax_number": "425-656-4096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7203 129TH AVE SE",
            "city": "NEWCASTLE",
            "state": "WA",
            "postal_code": "980561412",
            "telephone_number": "425-656-5406",
            "fax_number": "425-656-5040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARAGH",
        "first_name": "LETICIA",
        "middle_name": "AYALA",
        "credential": "ML",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2014-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60508339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LETICIA",
            "last_name": "AYALA",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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