Stacy Dee Vescial, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

AT2305 Issued in CA

Practice address

1305 Alexander St
Centralia, WA 98531-1305

Phone

(360) 736-2823

NPI assigned

Jun 2, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1212364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384473600000",
    "number": "1174782403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8040 KENTON LN SE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985016884",
            "telephone_number": "360-704-9790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 ALEXANDER ST",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985311305",
            "telephone_number": "360-736-2823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VESCIAL",
        "first_name": "STACY",
        "middle_name": "DEE",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-02",
        "last_updated": "2013-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "AT2305",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "P1 60047590",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Vander Heide, BSN, RN
• Caleb N Vanderhoof
• Lizzette Guadalupe Vargas
• Angelina Francisca Velasquez
• Tonja Evonne Vernon, CDPT
• Kimberly Ann Vetter, OTR
• Brenda M Viznaugh-Milton, DC
• Vocal Labs, Inc.
• James Allan Vranna Jr., PT
• Crystal Pauline Wade

• Physical Therapy Assistant in Centralia, WA
• Providers in Centralia, WA by specialty
• Physical Therapy Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2013; 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.