Active NPI
Alesia L Babakova, LMT
- Specialist
- Vancouver, WA
National Provider Identifier
1598071615
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 16263
- Practice address
- 12014 SE Mill Plain Blvd
S120
Vancouver, WA 98684-4043 - Phone
- (360) 891-0199
- NPI assigned
- Aug 26, 2010
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | 16263 | OR | Primary |
Addresses
Primary practice location
12014 SE Mill Plain Blvd
S120
Vancouver, WA 98684-4043
Mailing address
17223 SE Division St
Portland, OR 97236-1240
Phone (503) 760-0778
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 |
|---|---|---|---|
| 16263 | OR | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1282780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1282780800000",
"number": "1598071615",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17223 SE DIVISION ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972361240",
"telephone_number": "503-760-0778"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12014 SE MILL PLAIN BLVD",
"address_2": "S120",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986844043",
"telephone_number": "360-891-0199"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BABAKOVA",
"first_name": "ALESIA",
"middle_name": "L",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-08-26",
"last_updated": "2010-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "OR",
"license": "16263",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.