Active NPI
Larry Vern Smalley Jr.
- Technician
- Everett, WA
National Provider Identifier
1811678519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Technician
- License
- CM60901639
- Practice address
- 4526 Federal Ave
Everett, WA 98203-2132 - Phone
- (425) 349-6200
- NPI assigned
- Jul 26, 2023
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Technician | 374700000X | CM60901639 | WA | Primary |
Addresses
Primary practice location
4526 Federal Ave
Everett, WA 98203-2132
Mailing address
PO Box 25533
Federal Way, WA 98093-2533
Phone (253) 886-7762
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 |
|---|---|---|---|
| CM60901639 | WA | MD | Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1690329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690329600000",
"number": "1811678519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 25533",
"city": "FEDERAL WAY",
"state": "WA",
"postal_code": "980932533",
"telephone_number": "253-886-7762"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4526 FEDERAL AVE",
"city": "EVERETT",
"state": "WA",
"postal_code": "982032132",
"telephone_number": "425-349-6200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMALLEY",
"first_name": "LARRY",
"middle_name": "VERN",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-07-26",
"last_updated": "2023-07-26",
"certification_date": "2023-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "374700000X",
"taxonomy_group": "",
"desc": "Technician",
"state": "WA",
"license": "CM60901639",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Everett, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.