VA

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

License

RN00163709 Issued in WA

Legal business name

VA

Practice address

13119 149TH St E
Puyallup, WA 98374-9487

Phone

(253) 686-7017

NPI assigned

Sep 17, 2007

Organization subpart

No

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

Authorized official

Name

Patrick Carroll Kusander

Title

RN

Phone

(253) 686-7017

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1189987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189987200000",
    "number": "1487840146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13119 149TH ST E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983749487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13119 149TH ST E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983749487",
            "telephone_number": "253-686-7017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-17",
        "last_updated": "2007-09-17",
        "status": "A",
        "authorized_official_last_name": "KUSANDER",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "CARROLL",
        "authorized_official_title_or_position": "RN",
        "authorized_official_telephone_number": "253-686-7017"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "WA",
            "license": "RN00163709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.

Verify at the official NPI Registry.