Individual provider Active NPI

Deborah J. Mauro, CRNA

  • Certified Registered Nurse Anesthetist
  • Tacoma, WA
National Provider Identifier
1447203328
Registry record updated Mar 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP30006495 Issued in WA
Practice address
414 6TH Ave
Tacoma, WA 98402-2332
Phone
(253) 260-7060
NPI assigned
May 19, 2006
Last updated
Mar 10, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X AP30006495 WA Primary
Registered Nurse 163W00000X RN0083064 WA

Addresses

Primary practice location

414 6TH Ave
Tacoma, WA 98402-2332

Mailing address

38021 Bay St NE
Hansville, WA 98340-7736
Phone (208) 596-3535

Other practice location 1

700 S Main St
Moscow, ID 83843-3056
Phone (208) 882-4511

Other identifiers 1

IdentifierTypeStateIssuer
9650623MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031223000416 WA Practitioner - Certified Registered Nurse Anesthetist (Crna) 7113825472 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN0083064WAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
The Aesthetic Surgery Centre, PLLC CurrentSince May 2, 2022 Accepting new patients

Locations

2202 S Cedar St
Ste 100
Tacoma, WA 98405
Phone (253) 627-2900

2202 S Cedar St
Ste 150
Tacoma, WA 98405
Phone (253) 627-2900

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646870400000",
    "number": "1447203328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38021 BAY ST NE",
            "city": "HANSVILLE",
            "state": "WA",
            "postal_code": "983407736",
            "telephone_number": "208-596-3535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 6TH AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984022332",
            "telephone_number": "253-260-7060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 S Main St",
            "address_purpose": "LOCATION",
            "city": "Moscow",
            "state": "ID",
            "postal_code": "838433056",
            "country_code": "US",
            "telephone_number": "208-882-4511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAURO",
        "first_name": "DEBORAH",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP30006495",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN0083064",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9650623",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.