Individual provider Active NPI

Shanaka Miller, L.M.P.

  • Specialist
  • Lacey, WA
National Provider Identifier
1003933557
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA00011258 Issued in WA
Practice address
1320 College St SE
Lacey, WA 98503-2366
Phone
(360) 459-1320
Fax
(360) 923-1940
NPI assigned
Mar 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA00011258 WA Primary

Addresses

Primary practice location

1320 College St SE
Lacey, WA 98503-2366

Mailing address

1320 College St SE
Lacey, WA 98503-2366
Phone (360) 459-1320

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MA00011258WAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Jeffrey S Grant PS Past Accepting new patients
KM Stamwitz PLLC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003933557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 COLLEGE ST SE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985032366",
            "telephone_number": "360-459-1320",
            "fax_number": "360-923-1940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 COLLEGE ST SE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985032366",
            "telephone_number": "360-459-1320",
            "fax_number": "360-923-1940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "SHANAKA",
        "name_prefix": "Mrs.",
        "credential": "L.M.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA00011258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lacey, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.