Organization Active NPI

Mark a. Lucianna MD

  • Primary Care Clinic/Center
  • Arlington, WA
National Provider Identifier
1750581047
Registry record updated Jul 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
MARK A. LUCIANNA MD
Practice address
7530 204TH St NE
Arlington, WA 98223-8912
Phone
(360) 435-7337
Fax
(360) 435-3510
NPI assigned
Jul 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2007

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

Authorized official

Name
Ms. Luanne Vanwinkle
Title
Manager
Phone
(360) 435-7337

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

7530 204TH St NE
Arlington, WA 98223-8912

Mailing address

7530 204TH St NE
Arlington, WA 98223-8912
Phone (360) 435-7337

Other identifiers 2

IdentifierTypeStateIssuer
7112196MedicaidWA
0152577OtherWADEPT. OF LABOR AND INDUST

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1185235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185235200000",
    "number": "1750581047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7530 204TH ST NE",
            "city": "ARLINGTON",
            "state": "WA",
            "postal_code": "982238912",
            "telephone_number": "360-435-7337",
            "fax_number": "360-435-3510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7530 204TH ST NE",
            "city": "ARLINGTON",
            "state": "WA",
            "postal_code": "982238912",
            "telephone_number": "360-435-7337",
            "fax_number": "360-435-3510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK A. LUCIANNA MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-24",
        "last_updated": "2007-07-24",
        "status": "A",
        "authorized_official_last_name": "VANWINKLE",
        "authorized_official_first_name": "LUANNE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "360-435-7337",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7112196",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT. OF LABOR AND INDUST",
            "identifier": "0152577",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.

Verify at the official NPI Registry.