Active NPI
David Louis Polage, MD
- Pediatrics Physician
- Selah, WA
National Provider Identifier
1083850242
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 00012820
- Practice address
- 609 Speyers Rd
B39-15 Yakima Valley School
Selah, WA 98942-1099 - Phone
- (509) 698-1300
- Fax
- (509) 697-2230
- NPI assigned
- Dec 18, 2008
- Last updated
- Dec 18, 2008
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 00012820 | WA | Primary |
Addresses
Primary practice location
609 Speyers Rd
B39-15 Yakima Valley School
Selah, WA 98942-1099
Mailing address
609 Speyers Road
B39-15 Yakima Valley School
Selah, WA 98942-1099
Phone (509) 698-1300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150303000334 | WA | Order and Referring Only - Pediatric Medicine | 8527384940 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1229558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1229558400000",
"number": "1083850242",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "609 SPEYERS ROAD",
"address_2": "B39-15 YAKIMA VALLEY SCHOOL",
"city": "SELAH",
"state": "WA",
"postal_code": "989421099",
"telephone_number": "509-698-1300",
"fax_number": "509-697-2230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "609 SPEYERS RD",
"address_2": "B39-15 YAKIMA VALLEY SCHOOL",
"city": "SELAH",
"state": "WA",
"postal_code": "989421099",
"telephone_number": "509-698-1300",
"fax_number": "509-697-2230"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLAGE",
"first_name": "DAVID",
"middle_name": "LOUIS",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-12-18",
"last_updated": "2008-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WA",
"license": "00012820",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Selah, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.