Active NPI
Thi Tuyet Mai Ta, MD
- Nutritionist
- Kent, WA
National Provider Identifier
1124716592
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutritionist
- License
- NU61253261
- Practice address
- 4516 S 220TH PL Unit 63
Kent, WA 98032-1812 - Phone
- (206) 742-8051
- NPI assigned
- Apr 25, 2023
- 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 |
|---|---|---|---|---|
| Nutritionist | 133N00000X | NU61253261 | WA | Primary |
Addresses
Primary practice location
4516 S 220TH PL Unit 63
Kent, WA 98032-1812
Mailing address
4516 S 220TH PL Unit 63
Kent, WA 98032-1812
Phone (206) 742-8051
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NU61253261 | WA | MD | Nutritionist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1682380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682380800000",
"number": "1124716592",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4516 S 220TH PL UNIT 63",
"city": "KENT",
"state": "WA",
"postal_code": "980321812",
"telephone_number": "206-742-8051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4516 S 220TH PL UNIT 63",
"city": "KENT",
"state": "WA",
"postal_code": "980321812",
"telephone_number": "206-742-8051"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TA",
"first_name": "THI TUYET MAI",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-04-25",
"last_updated": "2023-04-25",
"certification_date": "2023-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": "WA",
"license": "NU61253261",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kent, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.