Active NPI
Daniel M Nambo, RT, HCA
- Radiologic Technologist
- Ellensburg, WA
National Provider Identifier
1316345218
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiologic Technologist
- License
- XT60353146
- 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, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| PC60347734 | WA | MD | Phlebotomy Technician |
| XT60353146 | WA | MD | Radiologic Technologist |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Health Service Clinic/Center
- Ellensburg, WA
- NPI 1548460025
-
- Nurse Practitioner
- Yakima, WA
- NPI 1689733032
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.