Matthew Vaughn

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

A160508656 Issued in WA

Practice address

6741 NE 182ND St
Unit C313
Kenmore, WA 98028

Phone

(209) 609-0476

NPI assigned

Aug 7, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1502064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1356866776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6741 NE 182ND ST UNIT C313",
            "city": "KENMORE",
            "state": "WA",
            "postal_code": "980285011",
            "telephone_number": "209-609-0476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6741 NE 182ND ST",
            "address_2": "UNIT C313",
            "city": "KENMORE",
            "state": "WA",
            "postal_code": "98028",
            "telephone_number": "209-609-0476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN",
        "first_name": "MATTHEW",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-07",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WA",
            "license": "A160508656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sean Vincent Toly, LMP
• Emily My an Thi Tran, PHARMD
• Justin Lamont Traver, LMP
• Danielle Marie Tunison, RDA
• Brittany Van Hal, DPT
• Jodi Renee Vingelen, N.D.
• Elizabeth Mylan Vu, DPT
• Thunya T Walker, OD
• Carli N Wall
• Jun Wang

• Athletic Trainer in Kenmore, WA
• Providers in Kenmore, WA by specialty
• Athletic Trainer in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.