Active NPI
Traci Mattox, CNA
- Technician
- Ritzville, WA
National Provider Identifier
1184083883
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Technician
- License
- NC10083060
- Practice address
- 903 S Adams St
Ritzville, WA 99169-2227 - Phone
- (509) 659-5408
- Fax
- (509) 659-0522
- NPI assigned
- Feb 23, 2016
- 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 |
|---|---|---|---|---|
| Technician | 374700000X | NC10083060 | WA | Primary |
Addresses
Primary practice location
903 S Adams St
Ritzville, WA 99169-2227
Mailing address
903 S Adams St
Ritzville, WA 99169-2227
Phone (509) 659-5408
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 |
|---|---|---|---|
| NC10083060 | WA | MD | Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1456185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456185600000",
"number": "1184083883",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "903 S ADAMS ST",
"city": "RITZVILLE",
"state": "WA",
"postal_code": "991692227",
"telephone_number": "509-659-5408",
"fax_number": "509-659-0522"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "903 S ADAMS ST",
"city": "RITZVILLE",
"state": "WA",
"postal_code": "991692227",
"telephone_number": "509-659-5408",
"fax_number": "509-659-0522"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTOX",
"first_name": "TRACI",
"credential": "CNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-02-23",
"last_updated": "2016-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "374700000X",
"taxonomy_group": "",
"desc": "Technician",
"state": "WA",
"license": "NC10083060",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ritzville, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.