Individual provider Active NPI

Pajyeebsuab Vang, COTA

  • Contractor
  • Richland, WA
National Provider Identifier
1073970828
Registry record updated Jan 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
License
OC60451655 Issued in WA
Practice address
1914 George Washington Way
Apt B
Richland, WA 99354-2343
Phone
(509) 318-5548
NPI assigned
Jan 25, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X OC60451655 WA Primary

Addresses

Primary practice location

1914 George Washington Way
Apt B
Richland, WA 99354-2343

Mailing address

1914 George Washington Way
Apt B
Richland, WA 99354-2343
Phone (509) 318-5548

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
OC60451655WAMDContractor

NPI Registry JSON

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

{
    "created_epoch": "1453680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453680000000",
    "number": "1073970828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1914 GEORGE WASHINGTON WAY",
            "address_2": "APT B",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993542343",
            "telephone_number": "509-318-5548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1914 GEORGE WASHINGTON WAY",
            "address_2": "APT B",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993542343",
            "telephone_number": "509-318-5548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANG",
        "first_name": "PAJYEEBSUAB",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-25",
        "last_updated": "2016-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "WA",
            "license": "OC60451655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2016; 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.