Individual provider Active NPI

Mary Jane Paterno, PHYSICAL THERAPIST

  • Pediatric Physical Therapist
  • Vancouver, WA
National Provider Identifier
1760720338
Registry record updated Jan 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
00003704 Issued in WA
Practice address
13501 NE 28TH St
Vancouver, WA 98682-8091
Phone
(360) 604-6700
NPI assigned
Jan 16, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 00003704 WA Primary

Addresses

Primary practice location

13501 NE 28TH St
Vancouver, WA 98682-8091

Mailing address

13501 NE 28TH St
Vancouver, WA 98682-8091
Phone (360) 604-6700

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

LicenseStateTypeSpecialty
00003704WAMDPediatric Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1358294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358294400000",
    "number": "1760720338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13501 NE 28TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986828091",
            "telephone_number": "360-604-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13501 NE 28TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986828091",
            "telephone_number": "360-604-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATERNO",
        "first_name": "MARY",
        "middle_name": "JANE",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-16",
        "last_updated": "2013-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "WA",
            "license": "00003704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2013; 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.