Active NPI
Mary E Klueber, PTA
- Physical Therapy Assistant
- Auburn, WA
National Provider Identifier
1255617528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 60133000
- Practice address
- 207 E St SW Apt 4
Auburn, WA 98001-5277 - Phone
- (206) 265-2881
- NPI assigned
- Oct 31, 2011
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 60133000 | WA | Primary |
Addresses
Primary practice location
207 E St SW Apt 4
Auburn, WA 98001-5277
Mailing address
207 E St SW Apt 4
Auburn, WA 98001-5277
Phone (206) 265-2881
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 |
|---|---|---|---|
| 60133000 | WA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320019200000",
"number": "1255617528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "207 E ST SW APT 4",
"city": "AUBURN",
"state": "WA",
"postal_code": "980015277",
"telephone_number": "206-265-2881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "207 E ST SW APT 4",
"city": "AUBURN",
"state": "WA",
"postal_code": "980015277",
"telephone_number": "206-265-2881"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLUEBER",
"first_name": "MARY",
"middle_name": "E",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-10-31",
"last_updated": "2011-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "WA",
"license": "60133000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Auburn, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.