Individual provider Active NPI

Nicole Denise Pullen-Umhra, LMFTA

  • Marriage & Family Therapist
  • Tacoma, WA
National Provider Identifier
1093376766
Registry record updated Sep 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MG60956276 Issued in WA
Practice address
4301 S Pine St Ste 30-08
Tacoma, WA 98409-9123
Phone
(253) 301-4983
NPI assigned
Jun 24, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MG60956276 WA Primary

Addresses

Primary practice location

4301 S Pine St Ste 30-08
Tacoma, WA 98409-9123

Mailing address

4301 S Pine St Ste 30-08
Tacoma, WA 98409-9123
Phone (253) 301-4983

Other practice location 1

12511 Meridian E Ste 201
Puyallup, WA 98373-3425
Phone (253) 881-1428

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
MG60956276WAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sharon Y Young, LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1561334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1093376766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 S PINE ST STE 30-08",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984099123",
            "telephone_number": "253-301-4983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 S PINE ST STE 30-08",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984099123",
            "telephone_number": "253-301-4983"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12511 Meridian E Ste 201",
            "address_purpose": "LOCATION",
            "city": "Puyallup",
            "state": "WA",
            "postal_code": "983733425",
            "country_code": "US",
            "telephone_number": "253-881-1428",
            "fax_number": "253-446-7137",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PULLEN-UMHRA",
        "first_name": "NICOLE",
        "middle_name": "DENISE",
        "credential": "LMFTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-24",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "MG60956276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; 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.