Individual provider Active NPI

Joie Gloudeman

  • Physical Therapy Assistant
  • Puyallup, WA
National Provider Identifier
1154065944
Registry record updated Apr 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
P160467974 Issued in WA
Practice address
1813 S Meridian
Puyallup, WA 98371-7807
Phone
(253) 697-9779
NPI assigned
Apr 26, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X P160467974 WA Primary
Physical Therapy Assistant 225200000X 60467974 WA

Addresses

Primary practice location

1813 S Meridian
Puyallup, WA 98371-7807

Mailing address

521 S 53Rd St
Tacoma, WA 98408-6550
Phone (360) 770-0585

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
60467974WAMDPhysical Therapy Assistant
P160467974WAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1650931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650931200000",
    "number": "1154065944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 S 53RD ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984086550",
            "telephone_number": "360-770-0585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1813 S MERIDIAN",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983717807",
            "telephone_number": "253-697-9779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLOUDEMAN",
        "first_name": "JOIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-26",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "P160467974",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "60467974",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2022; 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.