Active NPI
Macey Royann Bentley, LA,LMP
- Specialist
- Kent, WA
National Provider Identifier
1346492485
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MA00023363
- Practice address
- 202 W Gowe St
Suite B
Kent, WA 98032-5858 - Phone
- (253) 854-2499
- NPI assigned
- Oct 21, 2008
- 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 | MA00023363 | WA | Primary |
Addresses
Primary practice location
202 W Gowe St
Suite B
Kent, WA 98032-5858
Mailing address
202 W Gowe St
Suite B
Kent, WA 98032-5858
Phone (253) 854-2499
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 |
|---|---|---|---|
| MA00023363 | WA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1224547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1224547200000",
"number": "1346492485",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "202 W GOWE ST",
"address_2": "SUITE B",
"city": "KENT",
"state": "WA",
"postal_code": "980325858",
"telephone_number": "253-854-2499"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "202 W GOWE ST",
"address_2": "SUITE B",
"city": "KENT",
"state": "WA",
"postal_code": "980325858",
"telephone_number": "253-854-2499"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENTLEY",
"first_name": "MACEY",
"middle_name": "ROYANN",
"name_prefix": "Ms.",
"credential": "LA,LMP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-10-21",
"last_updated": "2008-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WA",
"license": "MA00023363",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kent, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.