Individual provider Active NPI

Gloria Triebenbach

  • Licensed Practical Nurse
  • Poulsbo, WA
National Provider Identifier
1346785557
Registry record updated Dec 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LP00047467 Issued in WA
Practice address
21628 Bond Rd NE
Poulsbo, WA 98370-9034
Phone
(360) 509-9085
Fax
(360) 697-1761
NPI assigned
Dec 23, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LP00047467 WA Primary

Addresses

Primary practice location

21628 Bond Rd NE
Poulsbo, WA 98370-9034

Mailing address

21628 Bond Rd NE
Poulsbo, WA 98370-9034
Phone (360) 509-9085

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
LP00047467WAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1482451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482451200000",
    "number": "1346785557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21628 BOND RD NE",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983709034",
            "telephone_number": "360-509-9085",
            "fax_number": "360-697-1761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21628 BOND RD NE",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983709034",
            "telephone_number": "360-509-9085",
            "fax_number": "360-697-1761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIEBENBACH",
        "first_name": "GLORIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-23",
        "last_updated": "2016-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WA",
            "license": "LP00047467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poulsbo, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2016; 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.