Active NPI
Georgia Cuddeback, L.M.P.
- Mechanotherapist
- University Place, WA
National Provider Identifier
1174864540
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mechanotherapist
- License
- MA00020373
- Practice address
- 8019 44TH St W # B
University Place, WA 98466-3017 - Phone
- (253) 678-8704
- NPI assigned
- Mar 11, 2013
- 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 |
|---|---|---|---|---|
| Mechanotherapist | 172M00000X | MA00020373 | WA | Primary |
Addresses
Primary practice location
8019 44TH St W # B
University Place, WA 98466-3017
Mailing address
8019 44TH St W # B
University Place, WA 98466-3017
Phone (253) 678-8704
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
| License | State | Type | Specialty |
|---|---|---|---|
| MA00020373 | WA | MD | Mechanotherapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1362960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1362960000000",
"number": "1174864540",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8019 44TH ST W # B",
"city": "UNIVERSITY PLACE",
"state": "WA",
"postal_code": "984663017",
"telephone_number": "253-678-8704"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8019 44TH ST W # B",
"city": "UNIVERSITY PLACE",
"state": "WA",
"postal_code": "984663017",
"telephone_number": "253-678-8704"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CUDDEBACK",
"first_name": "GEORGIA",
"credential": "L.M.P.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-03-11",
"last_updated": "2013-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "172M00000X",
"taxonomy_group": "",
"desc": "Mechanotherapist",
"state": "WA",
"license": "MA00020373",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in University Place, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.