Gerry B Cercado Jr.
Individual provider Active NPI Registered Nurse · Kent, WA
NPI 1386534733 · NPPES record last updated Jul 8, 2025
Key facts
- NPI
- 1386534733
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- RN61444286 (WA)
- Practice address
- 20852 102ND PL SE
Kent, WA 98031-2070 - Phone
- (206) 422-5510
- NPI assigned
- Jul 8, 2025
- Sex
- Unspecified or another gender identity
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN61444286 | WA | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN61444286 | WA | Yes |
Addresses
Primary practice location
20852 102ND PL SE
Kent, WA 98031-2070
Mailing address
20852 102ND PL SE
Kent, WA 98031-2070
Other providers in Kent, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.