Individual provider Active NPI

Lanora Delores Martinez

  • Peer Specialist
  • Tacoma, WA
National Provider Identifier
1679192090
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
CG61065415 Issued in WA
Practice address
5410 N 44TH St
Tacoma, WA 98407-3715
Phone
(253) 759-9544
Fax
(253) 759-0138
NPI assigned
Apr 15, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Peer Specialist 175T00000X CG61065415 WA Primary

Addresses

Primary practice location

5410 N 44TH St
Tacoma, WA 98407-3715

Mailing address

5410 N 44TH St
Tacoma, WA 98407-3715
Phone (253) 759-9544

Other practice location 1

325 E Pioneer
Puyallup, WA 98372-3265
Phone (253) 697-8400

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

LicenseStateTypeSpecialty
CG61065415WAMDPeer Specialist

NPI Registry JSON

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

{
    "created_epoch": "1586908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1679192090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5410 N 44TH ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984073715",
            "telephone_number": "253-759-9544",
            "fax_number": "253-759-0138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5410 N 44TH ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984073715",
            "telephone_number": "253-759-9544",
            "fax_number": "253-759-0138"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "325 E Pioneer",
            "address_purpose": "LOCATION",
            "city": "Puyallup",
            "state": "WA",
            "postal_code": "983723265",
            "country_code": "US",
            "telephone_number": "253-697-8400",
            "fax_number": "253-697-3730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "LANORA",
        "middle_name": "DELORES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-15",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "WA",
            "license": "CG61065415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; 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.