Active NPI
Liam Jet Lafond Vaughn, DPT
- Physical Therapist
- Kirkland, WA
National Provider Identifier
1033985759
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT60477664
- Practice address
- 11800 NE 128TH St
Kirkland, WA 98034-7208 - Phone
- (425) 548-6952
- NPI assigned
- Dec 4, 2023
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT60477664 | WA | Primary |
Addresses
Primary practice location
11800 NE 128TH St
Kirkland, WA 98034-7208
Mailing address
2108 1St Ave W
Seattle, WA 98119-2619
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT60477664 | WA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1701648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731024000000",
"number": "1033985759",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2108 1ST AVE W",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981192619"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11800 NE 128TH ST",
"city": "KIRKLAND",
"state": "WA",
"postal_code": "980347208",
"telephone_number": "425-548-6952"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAUGHN",
"first_name": "LIAM",
"middle_name": "JET LAFOND",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "U",
"enumeration_date": "2023-12-04",
"last_updated": "2024-11-08",
"certification_date": "2024-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT60477664",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kirkland, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.