Active NPI
Brenda A Lago, LMP
- Specialist
- Yakima, WA
National Provider Identifier
1659671139
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MA6013778
- Practice address
- 4202 Summitview Ave
Yakima, WA 98908-2928 - Phone
- (509) 952-8122
- NPI assigned
- Oct 29, 2010
- Last updated
- Oct 29, 2010
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | MA6013778 | WA | Primary |
Addresses
Primary practice location
4202 Summitview Ave
Yakima, WA 98908-2928
Mailing address
563 Sheets Rd
Yakima, WA 98901-9309
Phone (509) 952-8122
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 |
|---|---|---|---|
| MA6013778 | WA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288310400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288310400000",
"number": "1659671139",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "563 SHEETS RD",
"city": "YAKIMA",
"state": "WA",
"postal_code": "989019309",
"telephone_number": "509-952-8122"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4202 SUMMITVIEW AVE",
"city": "YAKIMA",
"state": "WA",
"postal_code": "989082928",
"telephone_number": "509-952-8122"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAGO",
"first_name": "BRENDA",
"middle_name": "A",
"name_prefix": "Mrs.",
"credential": "LMP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-10-29",
"last_updated": "2010-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WA",
"license": "MA6013778",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yakima, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 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.