Active NPI
Miraflor Taboada
- Occupational Therapist
- Dupont, WA
National Provider Identifier
1508079922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT60188638
- Practice address
- 1584 McNeil St Ste 240
Dupont, WA 98327-8793 - Phone
- (253) 549-1524
- NPI assigned
- May 8, 2007
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 006855 | OH | |
| Occupational Therapist | 225X00000X | |||
| Occupational Therapist | 225X00000X | OT60188638 | WA | Primary |
Addresses
Primary practice location
1584 McNeil St Ste 240
Dupont, WA 98327-8793
Mailing address
2528 Teslin St
Juneau, AK 99801-9085
Phone (907) 958-6628
Other practice location 1
2901 Bridgeport Way W
University Place, WA 98466-4614
Phone (907) 957-6628
Other practice location 2
625 Probasco St
Cincinnati, OH 45220-2710
Phone (513) 281-2464 ext. 1144
Other practice location 3
909 S 336th St Ste 100
Federal Way, WA 98003-7394
Phone (253) 661-5166
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 006855 | OH | MD | Occupational Therapist |
| OT60188638 | WA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719360000000",
"number": "1508079922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2528 TESLIN ST",
"city": "JUNEAU",
"state": "AK",
"postal_code": "998019085",
"telephone_number": "907-958-6628"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1584 MCNEIL ST STE 240",
"city": "DUPONT",
"state": "WA",
"postal_code": "983278793",
"telephone_number": "253-549-1524"
}
],
"practiceLocations": [
{
"address_1": "2901 Bridgeport Way W",
"address_purpose": "LOCATION",
"city": "University Place",
"state": "WA",
"postal_code": "984664614",
"country_code": "US",
"telephone_number": "907-957-6628",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "625 Probasco St",
"address_purpose": "LOCATION",
"city": "Cincinnati",
"state": "OH",
"postal_code": "452202710",
"country_code": "US",
"telephone_number": "513-281-2464 x1144",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "909 S 336th St Ste 100",
"address_purpose": "LOCATION",
"city": "Federal Way",
"state": "WA",
"postal_code": "980037394",
"country_code": "US",
"telephone_number": "253-661-5166",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TABOADA",
"first_name": "MIRAFLOR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-08",
"last_updated": "2024-06-26",
"certification_date": "2024-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "OH",
"license": "006855",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WA",
"license": "OT60188638",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Dupont, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.