Manuel Miranda Lata Jr., RN

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

RN60680518 Issued in WA

Practice address

505 29TH St SE
Auburn, WA 98002-7541

Phone

(253) 876-7650

Fax

(206) 302-2210

NPI assigned

May 21, 2018

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

Credentials

Registered Nurse

State licenses

Practice roles

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.

• Sound

  • Mental Illness Community Based Residential Treatment Facility
  • Auburn, WA
  • NPI 1053971234
  NPD (past)
• Sound

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tukwila, WA
  • NPI 1780774950
  NPD (past)

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

{
    "created_epoch": "1526860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526860800000",
    "number": "1386135895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 SOUTHCENTER BLVD",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981882547",
            "telephone_number": "206-901-2000",
            "fax_number": "206-901-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 29TH ST SE",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980027541",
            "telephone_number": "253-876-7650",
            "fax_number": "206-302-2210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATA",
        "first_name": "MANUEL",
        "middle_name": "MIRANDA",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-21",
        "last_updated": "2018-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "WA",
            "license": "RN60680518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Larson
• Jenelle D Larson, LMFT
• John Paul Larson, SUDPT
• Kevin Martin Larson, AAC
• Miki Larson, LMP
• Melissa Ann Lathum, CP 60277532
• Robbyn K Lattea, LMP
• Richard Lau
• Adoniram D Laureano, PHARMD
• Suzanne Laurel, DO

• Psychiatric/Mental Health Registered Nurse in Auburn, WA
• Providers in Auburn, WA by specialty
• Psychiatric/Mental Health Registered Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2018; 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.