Active NPI
Mickie Hucke, PT
- Physical Therapist
- Puyallup, WA
National Provider Identifier
1437229721
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT00002545
- Practice address
- 11019 Canyon Rd E
Suite C
Puyallup, WA 98373-3001 - Phone
- (253) 286-3600
- Fax
- (253) 286-3444
- NPI assigned
- Nov 8, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT00002545 | WA | Primary |
Addresses
Primary practice location
11019 Canyon Rd E
Suite C
Puyallup, WA 98373-3001
Mailing address
PO Box 731269
Puyallup, WA 98373-0060
Phone (253) 840-2313
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 199082 | Other | WA | DEPT OF LABOR & INDUSTRY |
| 7605719 | Other | WA | AETNA |
| 3912HU | Other | WA | REGENCE BLUE SHIELD |
| 8906542 | Other | WA | CRIME VICTIMS |
| 8430464 | Medicaid | WA |
Other names 1
- Mickie Gabriel
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT00002545 | WA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1437229721",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 731269",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983730060",
"telephone_number": "253-840-2313",
"fax_number": "253-840-6340"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11019 CANYON RD E",
"address_2": "SUITE C",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983733001",
"telephone_number": "253-286-3600",
"fax_number": "253-286-3444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUCKE",
"first_name": "MICKIE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT00002545",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT OF LABOR & INDUSTRY",
"identifier": "199082",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7605719",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUE SHIELD",
"identifier": "3912HU",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CRIME VICTIMS",
"identifier": "8906542",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8430464",
"state": "WA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MICKIE",
"last_name": "GABRIEL",
"credential": "PT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Puyallup, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.