Active NPI
Suzanna Louise Fuentes, LMP
- Mechanotherapist
- Shelton, WA
National Provider Identifier
1497927438
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mechanotherapist
- License
- MA23471
- Practice address
- SE 1061 Hwy 3
Shelton, WA 98584 - Phone
- (360) 427-7461
- Fax
- (360) 427-7680
- NPI assigned
- Mar 31, 2008
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Mechanotherapist | 172M00000X | MA23471 | WA | Primary |
Addresses
Primary practice location
SE 1061 Hwy 3
Shelton, WA 98584
Mailing address
SE 1061 Hwy 3
Shelton, WA 98584
Phone (360) 427-7461
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 |
|---|---|---|---|
| MA23471 | WA | MD | Mechanotherapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206921600000",
"number": "1497927438",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "SE 1061 HWY 3",
"city": "SHELTON",
"state": "WA",
"postal_code": "98584",
"telephone_number": "360-427-7461",
"fax_number": "360-427-7680"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "SE 1061 HWY 3",
"city": "SHELTON",
"state": "WA",
"postal_code": "98584",
"telephone_number": "360-427-7461",
"fax_number": "360-427-7680"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUENTES",
"first_name": "SUZANNA",
"middle_name": "LOUISE",
"name_prefix": "Mrs.",
"credential": "LMP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-31",
"last_updated": "2008-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "172M00000X",
"taxonomy_group": "",
"desc": "Mechanotherapist",
"state": "WA",
"license": "MA23471",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shelton, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.