Active NPI
Raymond D Dilworth, MD
- Family Medicine Physician
- Tacoma, WA
National Provider Identifier
1285607150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD00016656
- Practice address
- 1812 S J St
#102
Tacoma, WA 98405-4964 - Phone
- (253) 552-4900
- Fax
- (253) 627-1886
- NPI assigned
- Feb 9, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD00016656 | WA | Primary |
Addresses
Primary practice location
1812 S J St
#102
Tacoma, WA 98405-4964
Mailing address
1812 S J St
#102
Tacoma, WA 98405-4964
Phone (253) 552-4900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1445303 | Medicaid | WA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00016656 | WA | MD | Family Medicine Physician |
| 025209 | WA | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277942400000",
"number": "1285607150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1812 S J ST",
"address_2": "#102",
"city": "TACOMA",
"state": "WA",
"postal_code": "984054964",
"telephone_number": "253-552-4900",
"fax_number": "253-627-1886"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1812 S J ST",
"address_2": "#102",
"city": "TACOMA",
"state": "WA",
"postal_code": "984054964",
"telephone_number": "253-552-4900",
"fax_number": "253-627-1886"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DILWORTH",
"first_name": "RAYMOND",
"middle_name": "D",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-09",
"last_updated": "2010-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "MD00016656",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1445303",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.