Active NPI
Emily S Fortunato, MS, ATC, CSCS
- Athletic Trainer
- Tukwila, WA
National Provider Identifier
1174808331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- A161518232
- Practice address
- 14800 Starfire Way
Tukwila, WA 98188-8502 - Phone
- (301) 588-7888
- Fax
- (301) 588-3419
- NPI assigned
- Oct 19, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | A0000200 | MD | |
| Athletic Trainer | 2255A2300X | A161518232 | WA | Primary |
Addresses
Primary practice location
14800 Starfire Way
Tukwila, WA 98188-8502
Mailing address
14800 Starfire Way
Tukwila, WA 98188-8502
Phone (301) 588-7888
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
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A0000200 | MD | MD | Athletic Trainer |
| A161518232 | WA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710374400000",
"number": "1174808331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14800 STARFIRE WAY",
"city": "TUKWILA",
"state": "WA",
"postal_code": "981888502",
"telephone_number": "301-588-7888",
"fax_number": "301-588-3419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14800 STARFIRE WAY",
"city": "TUKWILA",
"state": "WA",
"postal_code": "981888502",
"telephone_number": "301-588-7888",
"fax_number": "301-588-3419"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORTUNATO",
"first_name": "EMILY",
"middle_name": "S",
"credential": "MS, ATC, CSCS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-10-19",
"last_updated": "2024-03-14",
"certification_date": "2024-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MD",
"license": "A0000200",
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "WA",
"license": "A161518232",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tukwila, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.