Active NPI
Mariland Elizabeth Drewery /Jackson
- Nurse's Aide
- Aurburn, WA
National Provider Identifier
1629415112
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse's Aide
- License
- 494200
- Practice address
- 2744 Ailpine Dr SE
Aurburn, WA 98002 - Phone
- (253) 333-9255
- Fax
- (253) 333-7913
- NPI assigned
- May 24, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | 494200 | WA | Primary |
Addresses
Primary practice location
2744 Ailpine Dr SE
Aurburn, WA 98002
Mailing address
2744 Ailpine Dr SE
Aurburn, WA 98002
Phone (253) 333-9255
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 |
|---|---|---|---|
| 494200 | WA | MD | Nurse's Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369353600000",
"number": "1629415112",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2744 AILPINE DR SE",
"city": "AURBURN",
"state": "WA",
"postal_code": "98002",
"telephone_number": "253-333-9255",
"fax_number": "253-333-7913"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2744 AILPINE DR SE",
"city": "AURBURN",
"state": "WA",
"postal_code": "98002",
"telephone_number": "253-333-9255",
"fax_number": "253-333-7913"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DREWERY /JACKSON",
"first_name": "MARILAND",
"middle_name": "ELIZABETH",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-05-24",
"last_updated": "2013-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "WA",
"license": "494200",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.