Active NPI
Marlyn Abauag Campos
- Clinic/Center
- Tacoma, WA
National Provider Identifier
1487734232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- License
- RN053748
- Practice address
- 9600 Veterans Dr SW
Tacoma, WA 98493-0003 - Phone
- (253) 583-1159
- NPI assigned
- Oct 16, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | RN053748 | GA | Primary |
Addresses
Primary practice location
9600 Veterans Dr SW
Tacoma, WA 98493-0003
Mailing address
9600 Veterans Dr SW
Tacoma, WA 98493-0003
Phone (253) 583-1159
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN053748 | GA | MD | Clinic/Center |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1487734232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9600 VETERANS DR SW",
"city": "TACOMA",
"state": "WA",
"postal_code": "984930003",
"telephone_number": "253-583-1159"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9600 VETERANS DR SW",
"city": "TACOMA",
"state": "WA",
"postal_code": "984930003",
"telephone_number": "253-583-1159"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPOS",
"first_name": "MARLYN",
"middle_name": "ABAUAG",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": "GA",
"license": "RN053748",
"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 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.