Individual provider Active NPI

Mariah Joy Tank, PT, DPT

  • Orthopedic Physical Therapist
  • Seattle, WA
National Provider Identifier
1154883601
Registry record updated Apr 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
Practice address
5410 California Ave SW # 101
Seattle, WA 98136-1562
Phone
(206) 913-8082
NPI assigned
Apr 3, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251X0800X WA Primary

Addresses

Primary practice location

5410 California Ave SW # 101
Seattle, WA 98136-1562

Mailing address

5410 California Ave SW # 101
Seattle, WA 98136-1562
Phone (206) 913-8082

Other practice location 1

17935 NE 65th St
Redmond, WA 98052-4925
Phone (206) 641-7733

Other identifiers 1

IdentifierTypeStateIssuer
NAOtherWANA

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1554249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586131200000",
    "number": "1154883601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5410 CALIFORNIA AVE SW # 101",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981361562",
            "telephone_number": "206-913-8082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5410 CALIFORNIA AVE SW # 101",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981361562",
            "telephone_number": "206-913-8082"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17935 NE 65th St",
            "address_purpose": "LOCATION",
            "city": "Redmond",
            "state": "WA",
            "postal_code": "980524925",
            "country_code": "US",
            "telephone_number": "206-641-7733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANK",
        "first_name": "MARIAH",
        "middle_name": "JOY",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-03",
        "last_updated": "2020-04-06",
        "certification_date": "2020-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NA",
            "identifier": "NA",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2020; 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.