Individual provider Active NPI

Paul Stanely Nutting

  • Social Worker
  • Lakewood, WA
National Provider Identifier
1285816413
Registry record updated Nov 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
9330 59TH Ave SW
Lakewood, WA 98499-2858
Phone
(253) 620-5742
NPI assigned
Nov 29, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary
Registered Nurse 163W00000X RC00058261 WA

Addresses

Primary practice location

9330 59TH Ave SW
Lakewood, WA 98499-2858

Mailing address

11321 N Astor Rd
Spokane, WA 99218-1605
Phone (509) 466-6722

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
RC00058261WAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1196294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196294400000",
    "number": "1285816413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11321 N ASTOR RD",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992181605",
            "telephone_number": "509-466-6722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9330 59TH AVE SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984992858",
            "telephone_number": "253-620-5742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUTTING",
        "first_name": "PAUL",
        "middle_name": "STANELY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-29",
        "last_updated": "2007-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RC00058261",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2007; 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.