Individual provider Active NPI

Stanley Alan Gruber, RN

  • Registered Nurse
  • Auburn, WA
National Provider Identifier
1851996540
Registry record updated May 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN60066292 Issued in WA
Practice address
30601 34TH PL S
Auburn, WA 98001-3201
Phone
(206) 225-0088
NPI assigned
Dec 1, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN60066292 WA Primary

Addresses

Primary practice location

30601 34TH PL S
Auburn, WA 98001-3201

Mailing address

18700 4TH Ave S
Burien, WA 98148-2012
Phone (206) 225-0088

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN60066292WAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1606780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1851996540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18700 4TH AVE S",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981482012",
            "telephone_number": "206-225-0088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30601 34TH PL S",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980013201",
            "telephone_number": "206-225-0088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUBER",
        "first_name": "STANLEY",
        "middle_name": "ALAN",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-01",
        "last_updated": "2021-05-25",
        "certification_date": "2021-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60066292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; 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.