Individual provider Active NPI

Shauna R Weatherby, ARNP

  • Women's Health Nurse Practitioner
  • Tacoma, WA
National Provider Identifier
1790785764
Registry record updated Jul 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
AP0001461 Issued in WA
Practice address
314 Martin Luther King Jr Way
Ste 104
Tacoma, WA 98405-4250
Phone
(253) 272-5572
Fax
(253) 272-5699
NPI assigned
Jul 29, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X AP0001461 WA Primary

Addresses

Primary practice location

314 Martin Luther King Jr Way
Ste 104
Tacoma, WA 98405-4250

Mailing address

314 Martin Luther King Jr Way
Ste 104
Tacoma, WA 98405-4250
Phone (253) 272-5572

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP0001461WAMDWomen's Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309996800000",
    "number": "1790785764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 MARTIN LUTHER KING JR WAY",
            "address_2": "STE 104",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054250",
            "telephone_number": "253-272-5572",
            "fax_number": "253-272-5699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 MARTIN LUTHER KING JR WAY",
            "address_2": "STE 104",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054250",
            "telephone_number": "253-272-5572",
            "fax_number": "253-272-5699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEATHERBY",
        "first_name": "SHAUNA",
        "middle_name": "R",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-29",
        "last_updated": "2011-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "WA",
            "license": "AP0001461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2011; 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.