Individual provider Active NPI

Matthew D. Haggerty, L.M.P.

  • Specialist
  • Seattle, WA
National Provider Identifier
1013185446
Registry record updated Feb 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA00004064 Issued in WA
Practice address
1605 12TH Ave
Suite #1
Seattle, WA 98122-2467
Phone
(206) 860-7282
NPI assigned
Feb 19, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA00004064 WA Primary

Addresses

Primary practice location

1605 12TH Ave
Suite #1
Seattle, WA 98122-2467

Mailing address

1605 12TH Ave
Suite #1
Seattle, WA 98122-2467
Phone (206) 860-7282

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
MA00004064WAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1203379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203379200000",
    "number": "1013185446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 12TH AVE",
            "address_2": "SUITE #1",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981222467",
            "telephone_number": "206-860-7282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 12TH AVE",
            "address_2": "SUITE #1",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981222467",
            "telephone_number": "206-860-7282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGGERTY",
        "first_name": "MATTHEW",
        "middle_name": "D.",
        "name_prefix": "Mr.",
        "credential": "L.M.P.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-19",
        "last_updated": "2008-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA00004064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; 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.