Marisa Ivonne Vasquez, APTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2165126 Issued in WA

Practice address

532 Oregon St
Raymond, WA 98577-9142

Phone

(806) 930-0604

NPI assigned

Sep 9, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1631145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1649949959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 BINKLEY AVE",
            "city": "DUMAS",
            "state": "TX",
            "postal_code": "790293827",
            "telephone_number": "806-930-0604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "532 OREGON ST",
            "city": "RAYMOND",
            "state": "WA",
            "postal_code": "985779142",
            "telephone_number": "806-930-0604"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "224 Binkley Ave",
            "address_purpose": "LOCATION",
            "city": "Dumas",
            "state": "TX",
            "postal_code": "790293827",
            "country_code": "US",
            "telephone_number": "806-930-0604",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VASQUEZ",
        "first_name": "MARISA",
        "middle_name": "IVONNE",
        "credential": "APTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-09",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2165126",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "2165126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Willapa Harbor Care LLC

• Physical Therapy Assistant in Raymond, WA
• Providers in Raymond, WA by specialty
• Physical Therapy Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; 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.