Active NPI
Estefani Perete Gomez
- Contractor
- Olympia, WA
National Provider Identifier
1760017495
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 201275197
- Practice address
- 606 Lilly Rd NE Apt 324
Olympia, WA 98506-5169 - Phone
- (360) 338-2477
- NPI assigned
- Mar 3, 2020
- 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 |
|---|---|---|---|---|
| Contractor | 171W00000X | 201275197 | WA | Primary |
Addresses
Primary practice location
606 Lilly Rd NE Apt 324
Olympia, WA 98506-5169
Mailing address
606 Lilly Rd NE Apt 324
Olympia, WA 98506-5169
Phone (360) 338-2477
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 201275197 | WA | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583193600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583193600000",
"number": "1760017495",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "606 LILLY RD NE APT 324",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985065169",
"telephone_number": "360-338-2477"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "606 LILLY RD NE APT 324",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985065169",
"telephone_number": "360-338-2477"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERETE GOMEZ",
"first_name": "ESTEFANI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-03",
"last_updated": "2020-03-03",
"certification_date": "2020-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "WA",
"license": "201275197",
"primary": true
}
],
"identifiers": [],
"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 Mar 3, 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.