Active NPI
Bryan McCabe, ATC, NASE, PES
- Student in an Organized Health Care Education/Training Program
- Lakewood, WA
National Provider Identifier
1124446471
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- A1 60284579
- Practice address
- 7308 Bridgeport Way W Ste 103
Lakewood, WA 98499-8000 - Phone
- (253) 582-8142
- NPI assigned
- Apr 3, 2014
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | A1 60284579 | WA | Primary |
Addresses
Primary practice location
7308 Bridgeport Way W Ste 103
Lakewood, WA 98499-8000
Mailing address
2101 N Puget Sound Ave
Tacoma, WA 98406-5852
Phone (714) 488-4939
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 |
|---|---|---|---|
| A1 60284579 | WA | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1396483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1396483200000",
"number": "1124446471",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2101 N PUGET SOUND AVE",
"city": "TACOMA",
"state": "WA",
"postal_code": "984065852",
"telephone_number": "714-488-4939"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7308 BRIDGEPORT WAY W STE 103",
"city": "LAKEWOOD",
"state": "WA",
"postal_code": "984998000",
"telephone_number": "253-582-8142"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCABE",
"first_name": "BRYAN",
"name_prefix": "Mr.",
"credential": "ATC, NASE, PES",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-04-03",
"last_updated": "2014-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "WA",
"license": "A1 60284579",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakewood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.