Travis Af Base

Primary specialty

Military HospitalTaxonomy code 286500000X

Legal business name

TRAVIS AF BASE

Practice address

19728 SE 35TH Way
Camas, WA 98607-8855

Phone

(240) 888-5977

NPI assigned

Jun 8, 2013

Last updated

Jun 8, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Stephanie Mannel

Title

Transitionalyr Program Coordinator

Phone

(707) 423-7182

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1370649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370649600000",
    "number": "1316385628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19728 SE 35TH WAY",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986078855",
            "telephone_number": "240-888-5977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19728 SE 35TH WAY",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986078855",
            "telephone_number": "240-888-5977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRAVIS AF BASE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-08",
        "last_updated": "2013-06-08",
        "status": "A",
        "authorized_official_last_name": "MANNEL",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "TRANSITIONALYR PROGRAM COORDINATOR",
        "authorized_official_telephone_number": "707-423-7182"
    },
    "taxonomies": [
        {
            "code": "286500000X",
            "taxonomy_group": "",
            "desc": "Military Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2013; 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.