Active NPI
Frances Rose Southall, LMP
- Specialist
- Tacoma, WA
National Provider Identifier
1104079615
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MA00014272
- Practice address
- 6240 Tacoma Mall Blvd
Suite 104
Tacoma, WA 98409-6819 - Phone
- (253) 474-3569
- NPI assigned
- Oct 28, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Specialist | 174400000X | MA00014272 | WA | Primary |
Addresses
Primary practice location
6240 Tacoma Mall Blvd
Suite 104
Tacoma, WA 98409-6819
Mailing address
6240 Tacoma Mall Blvd
Suite 104
Tacoma, WA 98409-6819
Phone (253) 474-3569
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 |
|---|---|---|---|
| MA00014272 | WA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1225152000000",
"number": "1104079615",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6240 TACOMA MALL BLVD",
"address_2": "SUITE 104",
"city": "TACOMA",
"state": "WA",
"postal_code": "984096819",
"telephone_number": "253-474-3569"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6240 TACOMA MALL BLVD",
"address_2": "SUITE 104",
"city": "TACOMA",
"state": "WA",
"postal_code": "984096819",
"telephone_number": "253-474-3569"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOUTHALL",
"first_name": "FRANCES",
"middle_name": "ROSE",
"credential": "LMP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-10-28",
"last_updated": "2008-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WA",
"license": "MA00014272",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
- South Sound Inpatient Physicians, PLLC
- South Sound Medical Clinic Inc
- South Sound Pediatric Occupational Therapy
- South Tacoma Chiropractic and Rehabilitation, PLLC
- South Tacoma Dental LLC
- Southwest Arkansas Dialysis
- Southwest Portland Medical Clinic Inc
- Courtney Allyson Souza
- Patricia L Sowards
- SP Behavior Consulting, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.