Individual provider Active NPI

Tonya Nichole Despain, LMP

  • Specialist
  • Lynnwood, WA
National Provider Identifier
1356684195
Registry record updated Mar 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
60331549 Issued in WI
Practice address
16303 Highway 99 Ste 2B
Lynnwood, WA 98087-1453
Phone
(425) 242-4884
NPI assigned
Mar 30, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 60331549 WI Primary

Addresses

Primary practice location

16303 Highway 99 Ste 2B
Lynnwood, WA 98087-1453

Mailing address

19625 73Rd Ave W
Lynnwood, WA 98036-5803
Phone (425) 244-8883

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
Credentials
Master of Theology

State licenses

LicenseStateTypeSpecialty
60331549WIMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Applied Healthcare Associates, P.S PastSince Jul 1, 2000 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1364601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364601600000",
    "number": "1356684195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19625 73RD AVE W",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980365803",
            "telephone_number": "425-244-8883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16303 HIGHWAY 99 STE 2B",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980871453",
            "telephone_number": "425-242-4884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESPAIN",
        "first_name": "TONYA",
        "middle_name": "NICHOLE",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-30",
        "last_updated": "2013-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WI",
            "license": "60331549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 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.