NPIMap

Organization Active NPI

Alpine Foot & Ankle Clinic, PS

  • Foot & Ankle Surgery Podiatrist
  • Arlington, WA
National Provider Identifier
1629254339
Registry record updated Mar 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO676 Issued in WA
Legal business name
ALPINE FOOT & ANKLE CLINIC, PS
Practice address
17432 Smokey Point Blvd
Suite 103
Arlington, WA 98223-6363
Phone
(360) 653-2326
Fax
(360) 658-8944
NPI assigned
Jan 11, 2008
Last updated
Mar 7, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2008

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

Authorized official

Name
Dr. Fred J Hawley Jr., DPMNPI 1497701742
Title
President/Owner
Phone
(360) 653-2326

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X PO676 WA
Prosthetic/Orthotic Supplier 335E00000X PO676 WA
Foot & Ankle Surgery Podiatrist 213ES0103X PO676 WA Primary

Addresses

Primary practice location

17432 Smokey Point Blvd
Suite 103
Arlington, WA 98223-6363

Mailing address

17432 Smokey Point Blvd
Suite 103
Arlington, WA 98223-6363
Phone (360) 653-2326

Other identifiers 1

IdentifierTypeStateIssuer
7111271MedicaidWA

National Provider Directory

National Provider Directory

Locations

17432 Smokey Point Blvd
Ste 103
Arlington, WA 98223
Phone (360) 653-2326

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1200009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204848000000",
    "number": "1629254339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17432 SMOKEY POINT BLVD",
            "address_2": "SUITE 103",
            "city": "ARLINGTON",
            "state": "WA",
            "postal_code": "982236363",
            "telephone_number": "360-653-2326",
            "fax_number": "360-658-8944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17432 SMOKEY POINT BLVD",
            "address_2": "SUITE 103",
            "city": "ARLINGTON",
            "state": "WA",
            "postal_code": "982236363",
            "telephone_number": "360-653-2326",
            "fax_number": "360-658-8944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALPINE FOOT & ANKLE CLINIC, PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-11",
        "last_updated": "2008-03-07",
        "status": "A",
        "authorized_official_last_name": "HAWLEY",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "360-653-2326",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "WA",
            "license": "PO676",
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "WA",
            "license": "PO676",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "WA",
            "license": "PO676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7111271",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.

Verify at the official NPI Registry.