Individual provider Active NPI

Jeny L Lavorato, LMP

  • Specialist
  • Mount Vernon, WA
National Provider Identifier
1265605455
Registry record updated Apr 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA00016476 Issued in WA
Practice address
1519 S 2ND St
Mount Vernon, WA 98273-4807
Phone
(360) 419-9992
NPI assigned
Apr 8, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA00016476 WA Primary

Addresses

Primary practice location

1519 S 2ND St
Mount Vernon, WA 98273-4807

Mailing address

1609 S 3Rd St
Mount Vernon, WA 98273-4909
Phone (360) 419-9992

Other identifiers 1

IdentifierTypeStateIssuer
0165912OtherWASTATE OF WA L AND I

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
MA00016476WAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1207612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207612800000",
    "number": "1265605455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1609 S 3RD ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982734909",
            "telephone_number": "360-419-9992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1519 S 2ND ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982734807",
            "telephone_number": "360-419-9992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVORATO",
        "first_name": "JENY",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-08",
        "last_updated": "2008-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA00016476",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF WA L AND I",
            "identifier": "0165912",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2008; 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.