Individual provider Active NPI

Rafael Martin Morones III, RN

  • Registered Nurse
  • Puyallup, WA
National Provider Identifier
1295257137
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN60440145 Issued in WA
Practice address
17802 87TH Ave E
Puyallup, WA 98375
Phone
(253) 348-0440
NPI assigned
Jul 12, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 RN60440145 WA Primary

Addresses

Primary practice location

17802 87TH Ave E
Puyallup, WA 98375

Mailing address

17802 87TH Ave E
Puyallup, WA 98375-6244
Phone (253) 348-0440

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
RN60440145WAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1499817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1295257137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17802 87TH AVE E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983756244",
            "telephone_number": "253-348-0440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17802 87TH AVE E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "98375",
            "telephone_number": "253-348-0440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORONES",
        "first_name": "RAFAEL",
        "middle_name": "MARTIN",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-12",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60440145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.