Individual provider Active NPI

Daniel M Nambo, RT, HCA

  • Radiologic Technologist
  • Ellensburg, WA
National Provider Identifier
1316345218
Registry record updated Dec 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiologic TechnologistTaxonomy code 247100000X
License
XT60353146 Issued in WA
Practice address
400 E University Way
Ellensburg, WA 98926-7502
Phone
(509) 963-1881
Fax
(509) 963-1886
NPI assigned
Dec 9, 2014
Last updated
Dec 11, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebotomy Technician 246RP1900X PC60347734 WA
Radiologic Technologist 247100000X XT60353146 WA Primary

Addresses

Primary practice location

400 E University Way
Ellensburg, WA 98926-7502

Mailing address

400 E University Way
Ellensburg, WA 98926-7502
Phone (509) 963-1881

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
PC60347734WAMDPhlebotomy Technician
XT60353146WAMDRadiologic Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Washington University Student Health Counseling and Wellness Past Accepting new patients
Elizabeth a. Grose, Inc. Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1418083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418256000000",
    "number": "1316345218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E UNIVERSITY WAY",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989267502",
            "telephone_number": "509-963-1881",
            "fax_number": "509-963-1886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E UNIVERSITY WAY",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989267502",
            "telephone_number": "509-963-1881",
            "fax_number": "509-963-1886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAMBO",
        "first_name": "DANIEL",
        "middle_name": "M",
        "credential": "RT, HCA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-09",
        "last_updated": "2014-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": "WA",
            "license": "PC60347734",
            "primary": false
        },
        {
            "code": "247100000X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist",
            "state": "WA",
            "license": "XT60353146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellensburg, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2014; 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.