Specialty Athletic Training

Primary specialty

Health EducatorTaxonomy code 174H00000X

Legal business name

SPECIALTY ATHLETIC TRAINING

Practice address

501 SE Ellsworth Rd
Vancouver, WA 98664-5101

Phone

(503) 863-0512

NPI assigned

Feb 5, 2020

Last updated

Feb 5, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ryan Lockard, CSCS, CSPS

Title

Founder

Phone

(503) 863-0512

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1580860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580860800000",
    "number": "1699307959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9208 NE HIGHWAY 99 STE 107-117",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986658986",
            "telephone_number": "503-863-0512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 SE ELLSWORTH RD",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986645101",
            "telephone_number": "503-863-0512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALTY ATHLETIC TRAINING",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-05",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A",
        "authorized_official_last_name": "LOCKARD",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "503-863-0512",
        "authorized_official_credential": "CSCS, CSPS"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Health Educator in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Health Educator in Washington

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