Individual provider Active NPI

Toni Rene Bushnell, LMP

  • Specialist
  • Lynnwood, WA
National Provider Identifier
1407055593
Registry record updated Jul 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA00019887 Issued in WA
Practice address
15033 Hwy 99
Suite a
Lynnwood, WA 98087-2363
Phone
(425) 218-3295
NPI assigned
Jul 17, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA00019887 WA Primary

Addresses

Primary practice location

15033 Hwy 99
Suite a
Lynnwood, WA 98087-2363

Mailing address

15033 Hwy 99
Suite a
Lynnwood, WA 98087-2363
Phone (425) 218-3295

Other identifiers 1

IdentifierTypeStateIssuer
0195906OtherWADEPARTMENT OF LABOR AND I

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

State licenses

LicenseStateTypeSpecialty
MA00019887WAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184630400000",
    "number": "1407055593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15033 HWY 99",
            "address_2": "SUITE A",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980872363",
            "telephone_number": "425-218-3295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15033 HWY 99",
            "address_2": "SUITE A",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980872363",
            "telephone_number": "425-218-3295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSHNELL",
        "first_name": "TONI",
        "middle_name": "RENE",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-17",
        "last_updated": "2007-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA00019887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF LABOR AND I",
            "identifier": "0195906",
            "state": "WA"
        }
    ],
    "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 Jul 17, 2007; 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.