Individual provider Active NPI

Marvin L Gentry, ND

  • Naturopath
  • University Place, WA
National Provider Identifier
1518033190
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
NaturopathTaxonomy code 175F00000X
License
NT00001200 Issued in WA
Practice address
2607 Bridgeport Way W
Suite 1a
University Place, WA 98466-4700
Phone
(206) 708-9888
Fax
(866) 740-9424
NPI assigned
Nov 27, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Naturopath 175F00000X NT00001200 WA Primary

Addresses

Primary practice location

2607 Bridgeport Way W
Suite 1a
University Place, WA 98466-4700

Mailing address

2607 Bridgeport Way W
Suite 1a
University Place, WA 98466-4700
Phone (206) 708-9888

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

LicenseStateTypeSpecialty
NT00001200WAMDNaturopath

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1518033190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2607 BRIDGEPORT WAY W",
            "address_2": "SUITE 1A",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984664700",
            "telephone_number": "206-708-9888",
            "fax_number": "866-740-9424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2607 BRIDGEPORT WAY W",
            "address_2": "SUITE 1A",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984664700",
            "telephone_number": "206-708-9888",
            "fax_number": "866-740-9424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENTRY",
        "first_name": "MARVIN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "ND",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "WA",
            "license": "NT00001200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in University Place, 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.

Verify at the official NPI Registry.