Organization Active NPI

Mayhew PLLC

  • Sports Medicine (Family Medicine) Physician
  • Olympia, WA
National Provider Identifier
1679771190
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
DP00001622 Issued in WA
Legal business name
MAYHEW PLLC
Practice address
1607 Cooper Point Rd NW
Olympia, WA 98502-8325
Phone
(360) 866-4445
Fax
(360) 866-4577
NPI assigned
Jul 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Joanne H Mayhew, DONPI 1649369729
Title
Owner
Phone
(360) 866-4445

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QS0010X DP00001622 WA Primary

Addresses

Primary practice location

1607 Cooper Point Rd NW
Olympia, WA 98502-8325

Mailing address

1607 Cooper Point Rd NW
Olympia, WA 98502-8325
Phone (360) 866-4445

Other identifiers 1

IdentifierTypeStateIssuer
1113984MedicaidWA

National Provider Directory

National Provider Directory

Locations

1607 Cooper Point Rd NW
Olympia, WA 98502
Phone (206) 623-0922

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1183593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679771190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1607 COOPER POINT RD NW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985028325",
            "telephone_number": "360-866-4445",
            "fax_number": "360-866-4577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1607 COOPER POINT RD NW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985028325",
            "telephone_number": "360-866-4445",
            "fax_number": "360-866-4577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYHEW PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MAYHEW",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-866-4445",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": "WA",
            "license": "DP00001622",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1113984",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.