Deziaray Mata Butler

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

1168804 Issued in TX

Practice address

9040 Jackson Ave
Tacoma, WA 98431-0001

Phone

(253) 968-3105

NPI assigned

Sep 11, 2026

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jeniva Deziaray Butler Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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

{
    "created_epoch": "1789084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789084800000",
    "number": "1053221853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001",
            "telephone_number": "915-626-7806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001",
            "telephone_number": "253-968-3105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATA BUTLER",
        "first_name": "DEZIARAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-11",
        "last_updated": "2026-09-11",
        "certification_date": "2026-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "TX",
            "license": "1168804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENIVA",
            "last_name": "BUTLER",
            "middle_name": "DEZIARAY",
            "credential": "LPN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Yolonda Massey
• Nykelia Anecia Massingale
• Wafic A. Massry, M.D.
• Sylvia Grace Mast, DO
• Frank Harris Masters III, M.D., M.S.
• Robert L. Matekel, PT, DSC, OCS
• Angelita Mateo
• Lindsey Strong Materi, DNP, PMHNP-BC
• Patricia A Matestic, PH.D.
• Emmanuel Matheri

• Licensed Practical Nurse in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Licensed Practical Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.