Individual provider Active NPI

Christy Jayne Runde, LMP

  • Specialist
  • Brush Prairie, WA
National Provider Identifier
1245427780
Registry record updated Sep 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA00022060 Issued in WA
Practice address
13719 NE 223Rd CT
Brush Prairie, WA 98606-5620
Phone
(360) 891-1094
NPI assigned
Sep 28, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA00022060 WA Primary

Addresses

Primary practice location

13719 NE 223Rd CT
Brush Prairie, WA 98606-5620

Mailing address

13719 NE 223Rd CT
Brush Prairie, WA 98606-5620
Phone (360) 891-1094

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

LicenseStateTypeSpecialty
MA00022060WAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1190937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190937600000",
    "number": "1245427780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13719 NE 223RD CT",
            "city": "BRUSH PRAIRIE",
            "state": "WA",
            "postal_code": "986065620",
            "telephone_number": "360-891-1094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13719 NE 223RD CT",
            "city": "BRUSH PRAIRIE",
            "state": "WA",
            "postal_code": "986065620",
            "telephone_number": "360-891-1094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUNDE",
        "first_name": "CHRISTY",
        "middle_name": "JAYNE",
        "name_prefix": "Mrs.",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-28",
        "last_updated": "2007-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA00022060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brush Prairie, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2007; 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.