Active NPI
Lara M Dow
- Physical Therapist
- Redmond, WA
National Provider Identifier
1750459681
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT00009744
- Practice address
- 22500 NE Marketplace Dr
Suite 204
Redmond, WA 98053-2033 - Phone
- (425) 836-1034
- Fax
- (425) 836-1037
- NPI assigned
- Nov 30, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT00009744 | WA | Primary |
Addresses
Primary practice location
22500 NE Marketplace Dr
Suite 204
Redmond, WA 98053-2033
Mailing address
1519 132ND St SE
Suite a
Everett, WA 98208-7203
Phone (425) 330-0633
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5650DO | Other | WA | REGENCE/BS |
| 0211090 | Other | WA | DEPT. OF LABOR & INDUSTRY |
| 0007DO | Other | WA | REGENCE BLUE SHIELD |
| 4460DO | Other | WA | REGENCE BLUE SHIELD |
Other names 1
- Lara Marie Vinson
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT00009744 | WA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191974400000",
"number": "1750459681",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1519 132ND ST SE",
"address_2": "SUITE A",
"city": "EVERETT",
"state": "WA",
"postal_code": "982087203",
"telephone_number": "425-330-0633",
"fax_number": "425-338-9637"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22500 NE MARKETPLACE DR",
"address_2": "SUITE 204",
"city": "REDMOND",
"state": "WA",
"postal_code": "980532033",
"telephone_number": "425-836-1034",
"fax_number": "425-836-1037"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOW",
"first_name": "LARA",
"middle_name": "M",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-30",
"last_updated": "2007-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT00009744",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE/BS",
"identifier": "5650DO",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT. OF LABOR & INDUSTRY",
"identifier": "0211090",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUE SHIELD",
"identifier": "0007DO",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUE SHIELD",
"identifier": "4460DO",
"state": "WA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LARA",
"last_name": "VINSON",
"middle_name": "MARIE",
"credential": "MPT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Redmond, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.