Individual provider Active NPI

Malia N Vazquez, DPT

  • Physical Therapist
  • Bonney Lake, WA
National Provider Identifier
1740185743
Registry record updated Oct 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
10004 204TH Ave E Ste 3100
Bonney Lake, WA 98391-6540
Phone
(253) 987-7509
NPI assigned
Oct 9, 2026
Last updated
Oct 9, 2026By the provider in NPPES
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X WA Primary

Addresses

Primary practice location

10004 204TH Ave E Ste 3100
Bonney Lake, WA 98391-6540

Mailing address

4301 S Pine St Ste 600
Tacoma, WA 98409-7209

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1791504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791504000000",
    "number": "1740185743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 S PINE ST STE 600",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984097209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10004 204TH AVE E STE 3100",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983916540",
            "telephone_number": "253-987-7509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ",
        "first_name": "MALIA",
        "middle_name": "N",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2026-10-09",
        "last_updated": "2026-10-09",
        "certification_date": "2026-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonney Lake, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.