Active NPI
Samuel Waithaka
- Driver
- Puyallup, WA
National Provider Identifier
1295515377
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- License
- D14093C
- Practice address
- 5702 99TH Street CT E
Puyallup, WA 98373-1082 - Phone
- (253) 434-6821
- NPI assigned
- Oct 5, 2023
- Last updated
- Oct 5, 2023
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Driver | 172A00000X | D14093C | WA | Primary |
Addresses
Primary practice location
5702 99TH Street CT E
Puyallup, WA 98373-1082
Mailing address
5702 99TH Street CT E
Puyallup, WA 98373-1082
Phone (253) 434-6821
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
| License | State | Type | Specialty |
|---|---|---|---|
| D14093C | WA | MD | Driver |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1696464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696464000000",
"number": "1295515377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5702 99TH STREET CT E",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983731082",
"telephone_number": "253-434-6821"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5702 99TH STREET CT E",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983731082",
"telephone_number": "253-434-6821"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAITHAKA",
"first_name": "SAMUEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-10-05",
"last_updated": "2023-10-05",
"certification_date": "2023-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "WA",
"license": "D14093C",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Puyallup, WA
- Jeffrey Allen Waguespack, MSPT
- Kassondra Wagy, ARNP
- Jon Mark Wahlstrom, PTA
- Jessie Jean Waiamau-Ariota, LMHC
- Anne Waigi, RN NURSE DELEGATOR
- Edward E Wakatake, MD
- Wal-Mart Stores Inc. (Wal-Mart Vision Center 30-3525)
- Wal-Mart Stores, Inc (Vision Center 30-2403)
- Simone Antoinette Walcott
- Taylor Marie Waldron
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 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.