Individual provider Active NPI

Sisay S Jorga, LMP

  • Specialist
  • Lynnwood, WA
National Provider Identifier
1528401593
Registry record updated Apr 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA 60324977 Issued in WA
Practice address
16418 7TH PL W Ste B
Lynnwood, WA 98037-8100
Phone
(425) 741-3030
NPI assigned
Apr 9, 2013
Last updated
Apr 9, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA 60324977 WA Primary

Addresses

Primary practice location

16418 7TH PL W Ste B
Lynnwood, WA 98037-8100

Mailing address

12048 32ND Ave NE Apt 304
Seattle, WA 98125-5543
Phone (206) 407-4914

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
MA 60324977WAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1365465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365465600000",
    "number": "1528401593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12048 32ND AVE NE APT 304",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981255543",
            "telephone_number": "206-407-4914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16418 7TH PL W STE B",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980378100",
            "telephone_number": "425-741-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORGA",
        "first_name": "SISAY",
        "middle_name": "S",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-09",
        "last_updated": "2013-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA 60324977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2013; 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.