Active NPI
Tabatha Burris, LMP
- Specialist
- Renton, WA
National Provider Identifier
1326340456
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MA60160181
- Practice address
- 14410 Petrovistsky Rd SE #109
Renton, WA 98058 - Phone
- (425) 226-1856
- NPI assigned
- Nov 22, 2010
- 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 | MA60160181 | WA | Primary |
Addresses
Primary practice location
14410 Petrovistsky Rd SE #109
Renton, WA 98058
Mailing address
17533 151St Avenue SE Unit 8-9
Renton, WA 98058
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 |
|---|---|---|---|
| MA60160181 | WA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1290384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1290384000000",
"number": "1326340456",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17533 151ST AVENUE SE UNIT 8-9",
"city": "RENTON",
"state": "WA",
"postal_code": "98058"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14410 PETROVISTSKY RD SE #109",
"city": "RENTON",
"state": "WA",
"postal_code": "98058",
"telephone_number": "425-226-1856"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURRIS",
"first_name": "TABATHA",
"credential": "LMP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-11-22",
"last_updated": "2010-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WA",
"license": "MA60160181",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Renton, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.