Individual provider Active NPI

Mary Muth, PA-C, L.AC

  • Acupuncturist
  • University Place, WA
National Provider Identifier
1801807128
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC00002753 Issued in WA
Practice address
7210 40TH St W
Ste 100
University Place, WA 98466-4318
Phone
(253) 564-0170
Fax
(253) 207-4240
NPI assigned
Aug 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC00002753 WA Primary
Physician Assistant 363A00000X PA10002261 WA

Addresses

Primary practice location

7210 40TH St W
Ste 100
University Place, WA 98466-4318

Mailing address

7210 40TH St W
Ste 100
University Place, WA 98466-4318
Phone (253) 564-0170

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
AC00002753WAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Tanya Wilke Family Medicine Past Accepting new patients
White River Family Care LLC PastSince Feb 1, 2003 Accepting new patients
Franciscan Medical Group Past Accepting new patients
Fox Medical Center PastSince Jun 27, 2021 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10664/brand/1/csg/1/fhir/r4

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1801807128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7210 40TH ST W",
            "address_2": "STE 100",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984664318",
            "telephone_number": "253-564-0170",
            "fax_number": "253-207-4240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7210 40TH ST W",
            "address_2": "STE 100",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984664318",
            "telephone_number": "253-564-0170",
            "fax_number": "253-207-4240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTH",
        "first_name": "MARY",
        "credential": "PA-C, L.AC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "WA",
            "license": "AC00002753",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10002261",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in University Place, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.