Active NPI
Maria Geinah Labanero Gumban
- Physical Therapist
- Anacortes, WA
National Provider Identifier
1306547989
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT00010536
- Practice address
- 1105 27TH St
Anacortes, WA 98221-2710 - Phone
- (360) 293-3174
- NPI assigned
- Mar 13, 2023
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT00010536 | WA | Primary |
Addresses
Primary practice location
1105 27TH St
Anacortes, WA 98221-2710
Mailing address
125 Dallas St
Mount Vernon, WA 98274-3014
Phone (360) 630-7517
Other practice location 1
2120 E Division St
Mount Vernon, WA 98274-4639
Phone (360) 424-4258
Other practice location 2
1810 E Division St
Mount Vernon, WA 98274-6717
Phone (360) 424-7900
Other practice location 3
400 Gilkey Rd
Burlington, WA 98233-2907
Phone (360) 755-5550
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 |
|---|---|---|---|
| PT00010536 | WA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1678665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678665600000",
"number": "1306547989",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 DALLAS ST",
"city": "MOUNT VERNON",
"state": "WA",
"postal_code": "982743014",
"telephone_number": "360-630-7517"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1105 27TH ST",
"city": "ANACORTES",
"state": "WA",
"postal_code": "982212710",
"telephone_number": "360-293-3174"
}
],
"practiceLocations": [
{
"address_1": "2120 E Division St",
"address_purpose": "LOCATION",
"city": "Mount Vernon",
"state": "WA",
"postal_code": "982744639",
"country_code": "US",
"telephone_number": "360-424-4258",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1810 E Division St",
"address_purpose": "LOCATION",
"city": "Mount Vernon",
"state": "WA",
"postal_code": "982746717",
"country_code": "US",
"telephone_number": "360-424-7900",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "400 Gilkey Rd",
"address_purpose": "LOCATION",
"city": "Burlington",
"state": "WA",
"postal_code": "982332907",
"country_code": "US",
"telephone_number": "360-755-5550",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GUMBAN",
"first_name": "MARIA GEINAH",
"middle_name": "LABANERO",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-03-13",
"last_updated": "2023-03-13",
"certification_date": "2023-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT00010536",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anacortes, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 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.