Molly Marie Pedraza

Primary specialty

Diagnostic Ultrasound PhysicianTaxonomy code 2085U0001X

License

154672 Issued in GA

Practice address

9040 Jackson Ave
Tacoma, WA 98431-0001

Phone

(209) 518-9331

NPI assigned

Nov 20, 2019

Last updated

Nov 20, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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": "1574208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574208000000",
    "number": "1376189829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6075 TOWNES WAY",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319096043",
            "telephone_number": "109-518-9331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001",
            "telephone_number": "209-518-9331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDRAZA",
        "first_name": "MOLLY",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-20",
        "last_updated": "2019-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "GA",
            "license": "154672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.mamc.health.mil/",
            "affiliation": "N",
            "endpointDescription": "madigan army",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "9040 Jackson Ave",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984310001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• John Patrick Pedey-Braswell, PHARMD, BCPP, BCPS
• Pediatric Dental Care Center
• Pediatric Neurology Associates PS
• Pediatrics Northwest PS
• Pediatrix Cardiology of Washington, P.C.
• Melissa Anne Pedrozo, EAMP, LAC
• Cecilia Fayth Peebles
• Merritt Edward Peele, DPT
• Luiza Miranda Pegado, LPN
• Kara Louise Pegram, PHD

• Diagnostic Ultrasound Physician in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Diagnostic Ultrasound Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2019; 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.