NPIMap

Organization Active NPI

Pablo R Proano MD PS

  • Psychiatry Physician
  • Seattle, WA
National Provider Identifier
1447370366
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
20243 Issued in WA
Legal business name
PABLO R PROANO MD PS
Practice address
1229 Madison St
Ste 1210
Seattle, WA 98104-3586
Phone
(206) 386-3103
Fax
(206) 386-3123
NPI assigned
Apr 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Pablo R Proano, MDNPI 1639109036
Title
MD Corporate President
Phone
(206) 386-3103

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 20243 WA Primary

Addresses

Primary practice location

1229 Madison St
Ste 1210
Seattle, WA 98104-3586

Mailing address

17719 Pac Ave S Valley West Billing SVC
PMB 431
Spanaway, WA 98387-8334
Phone (253) 847-9195

Other identifiers 1

IdentifierTypeStateIssuer
1030220MedicaidWA

Other names 1

  • PABLO R PROANO MD PS Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070430000017 WA Part B Supplier - Clinic/Group Practice 9931205507 Receives reassigned benefits from 1 practitioner
Practice locations: Seattle, WA

National Provider Directory

National Provider Directory

Locations

1229 Madison St
Ste 1210
Seattle, WA 98104
Phone (206) 386-3103

21818 Mountain Hwy E
Spanaway, WA 98387

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1447370366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17719 PAC AVE S VALLEY WEST BILLING SVC",
            "address_2": "PMB 431",
            "city": "SPANAWAY",
            "state": "WA",
            "postal_code": "983878334",
            "telephone_number": "253-847-9195",
            "fax_number": "253-847-9292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1229 MADISON ST",
            "address_2": "STE 1210",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981043586",
            "telephone_number": "206-386-3103",
            "fax_number": "206-386-3123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PABLO R PROANO MD PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PROANO",
        "authorized_official_first_name": "PABLO",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MD CORPORATE PRESIDENT",
        "authorized_official_telephone_number": "206-386-3103",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "20243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1030220",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PABLO R PROANO MD PS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.