Individual provider Active NPI

Mary Ann Palotas, RN

  • Registered Nurse
  • College Place, WA
National Provider Identifier
1275975112
Registry record updated Jul 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN00063710 Issued in WA
Practice address
955 SE Garrison Dr
College Place, WA 99324-4009
Phone
(509) 386-5205
Fax
(509) 529-9858
NPI assigned
Jul 19, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN00063710 WA Primary

Addresses

Primary practice location

955 SE Garrison Dr
College Place, WA 99324-4009

Mailing address

955 SE Garrison Dr
College Place, WA 99324-4009
Phone (509) 386-5205

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN00063710WAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1374192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374451200000",
    "number": "1275975112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 SE GARRISON DR",
            "city": "COLLEGE PLACE",
            "state": "WA",
            "postal_code": "993244009",
            "telephone_number": "509-386-5205",
            "fax_number": "509-529-9858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 SE GARRISON DR",
            "city": "COLLEGE PLACE",
            "state": "WA",
            "postal_code": "993244009",
            "telephone_number": "509-386-5205",
            "fax_number": "509-529-9858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALOTAS",
        "first_name": "MARY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-19",
        "last_updated": "2013-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN00063710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in College Place, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.

Verify at the official NPI Registry.