Octavia Danielle Graves

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LP61249274 Issued in WA

Practice address

11306 8TH St E
Edgewood, WA 98372-1147

Phone

(253) 392-2135

NPI assigned

Aug 22, 2023

Last updated

Aug 22, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1692662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1285418145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 WHEELER ST S APT 212",
            "city": "PARKLAND",
            "state": "WA",
            "postal_code": "984443600",
            "telephone_number": "253-307-5138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11306 8TH ST E",
            "city": "EDGEWOOD",
            "state": "WA",
            "postal_code": "983721147",
            "telephone_number": "253-392-2135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVES",
        "first_name": "OCTAVIA",
        "middle_name": "DANIELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-22",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WA",
            "license": "LP61249274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Flannery, MFT
• John P Frostad, L.AC., E.A.M.P.
• Kristine Louise Garling, RN
• Jennifer Ann George, LMP
• Imelda D. Goyanko-Borromeo, MD
• Nathan Gray, LMP
• Seonghee Kim Han
• Holly Joy Harden, LMFTA
• Timothy Gerald Hardtke, DDS
• Bonnie Janette Harrison, LMP

• Licensed Practical Nurse in Edgewood, WA
• Providers in Edgewood, WA by specialty
• Licensed Practical Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; 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.