Individual provider Active NPI

Cynthia Dawn Fajmon, LMP

  • Specialist
  • Pasco, WA
National Provider Identifier
1790990877
Registry record updated Sep 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA00022178 Issued in WA
Practice address
4915 Flores Lane
Pasco, WA 99301
Phone
(509) 860-3576
NPI assigned
May 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA00022178 WA Primary

Addresses

Primary practice location

4915 Flores Lane
Pasco, WA 99301

Mailing address

4915 Flores LN
Pasco, WA 99301-7909
Phone (509) 860-3576

Other identifiers 1

IdentifierTypeStateIssuer
MA00022178OtherWAMASSAGE LICENSE

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
MA00022178WAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189468800000",
    "number": "1790990877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4915 FLORES LN",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993017909",
            "telephone_number": "509-860-3576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4915 FLORES LANE",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "99301",
            "telephone_number": "509-860-3576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAJMON",
        "first_name": "CYNTHIA",
        "middle_name": "DAWN",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-11",
        "last_updated": "2007-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA00022178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSAGE LICENSE",
            "identifier": "MA00022178",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasco, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.