Liberty Puyal Mace, I.M.T. (ASCPI)

Primary specialty

Medical TechnologistTaxonomy code 246QM0706X

Practice address

401 W Poplar St
Walla Walla, WA 99362-2846

Phone

(509) 897-5722

Fax

(509) 522-5724

NPI assigned

Dec 4, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Liberty Villanueva Puyal Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1701648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1437925278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1931 ALCO AVE",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993624353",
            "telephone_number": "509-899-8120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W POPLAR ST",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993622846",
            "telephone_number": "509-897-5722",
            "fax_number": "509-522-5724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACE",
        "first_name": "LIBERTY",
        "middle_name": "PUYAL",
        "name_prefix": "Mrs.",
        "credential": "I.M.T. (ASCPI)",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-04",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246QM0706X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Pathology, Medical Technologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LIBERTY",
            "last_name": "PUYAL",
            "middle_name": "VILLANUEVA",
            "prefix": "MS.",
            "credential": "I.M.T. (ASCPI)",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Emily Jade Lux
• Jaclyn M Lynch
• Allison Marie Lyons, LMP
• Futsun Lyth
• Courtney Michelle Maas
• Fantasia Marie Macedo
• Vanessa Maceo
• Mackenzie H. Craik, DDS, PLLC
• Lizbet Madrigal-Mendoza
• Alison Madsen

• Medical Technologist in Walla Walla, WA
• Providers in Walla Walla, WA by specialty
• Medical Technologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; 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.