Active NPI
Mary Ellen Pfeiffer, B.A., L.M.P.
- Specialist
- Bonney Lake, WA
National Provider Identifier
1316158108
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MA00011816
- Practice address
- 7621 171St Avenue CT E
Bonney Lake, WA 98391-7169 - Phone
- (253) 863-4714
- NPI assigned
- May 24, 2007
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | MA00011816 | WA | Primary |
Addresses
Primary practice location
7621 171St Avenue CT E
Bonney Lake, WA 98391-7169
Mailing address
7621 171St Avenue CT E
Bonney Lake, WA 98391-7169
Phone (253) 863-4714
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0100617 | Other | WA | LABOR AND INDUSTRIES |
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
- Bachelor of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA00011816 | WA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1316158108",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7621 171ST AVENUE CT E",
"city": "BONNEY LAKE",
"state": "WA",
"postal_code": "983917169",
"telephone_number": "253-863-4714"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7621 171ST AVENUE CT E",
"city": "BONNEY LAKE",
"state": "WA",
"postal_code": "983917169",
"telephone_number": "253-863-4714"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PFEIFFER",
"first_name": "MARY",
"middle_name": "ELLEN",
"credential": "B.A., L.M.P.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WA",
"license": "MA00011816",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR AND INDUSTRIES",
"identifier": "0100617",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bonney Lake, WA
- Sandra Lee Pearson, REGISTERED NURSE
- Holly Pennington, MPT
- Performance Sports and Spine Physical Therapy PS
- Brandon Edward Perkes, DC
- Alexandrea Lee Pettyjohn, LMP
- Crystal Gayle Phillips, COTA/L
- Gordon Arthur Pomerenke
- Emily R Potter, R.PH.
- Heather Lynn Prescott, LICSW
- Janessa Pallasigui Pressley, PHARM D
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.