NPIMap

Organization Active NPI

Mount Rainier Neurology Clinic and Diagnostic Center PS

  • Neurology Physician
  • Tacoma, WA
National Provider Identifier
1467505172
Registry record updated Sep 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
MOUNT RAINIER NEUROLOGY CLINIC AND DIAGNOSTIC CENTER PS
Practice address
1708 So. Yakima Ave
Ste118
Tacoma, WA 98405-5307
Phone
(253) 573-0460
Fax
(253) 573-0461
NPI assigned
Jan 18, 2007
Last updated
Sep 9, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2015

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

Authorized official

Name
Dr. Keyi Yang, MDNPI 1831177922
Title
President
Phone
(253) 573-0460

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
Neurology Physician 2084N0400X NU Primary

Addresses

Primary practice location

1708 So. Yakima Ave
Ste118
Tacoma, WA 98405-5307

Mailing address

4426 Paradise W Ave
University Place, WA 98466-1024
Phone (253) 565-3887

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070131000216 WA Part B Supplier - Clinic/Group Practice 0547261711 Receives reassigned benefits from 1 practitioner
Practice locations: University Place, WA

National Provider Directory

National Provider Directory

Locations

1708 Yakima Ave
Ste 118
Tacoma, WA 98405
Phone (253) 573-0460

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441756800000",
    "number": "1467505172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4426 PARADISE W AVE",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984661024",
            "telephone_number": "253-565-3887",
            "fax_number": "253-565-3887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1708 SO. YAKIMA AVE",
            "address_2": "STE118",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984055307",
            "telephone_number": "253-573-0460",
            "fax_number": "253-573-0461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNT RAINIER NEUROLOGY CLINIC AND DIAGNOSTIC CENTER PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2015-09-09",
        "status": "A",
        "authorized_official_last_name": "YANG",
        "authorized_official_first_name": "KEYI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "253-573-0460",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 9, 2015; 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.