Organization Active NPI

Proactive Functional Health PLLC

  • Adult Health Nurse Practitioner
  • Tacoma, WA
National Provider Identifier
1861284895
Registry record updated May 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
Legal business name
PROACTIVE FUNCTIONAL HEALTH PLLC
Practice address
2335 S I St
Tacoma, WA 98405-3816
Phone
(206) 326-8122
NPI assigned
May 17, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2025

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

Authorized official

Name
David Maniago, NPNPI 1790489813
Title
Nurse Practitioner/Owner
Phone
(206) 326-8122

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LA2200X Primary

Addresses

Primary practice location

2335 S I St
Tacoma, WA 98405-3816

Mailing address

2335 S I St
Tacoma, WA 98405-3816
Phone (206) 326-8122

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1747440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747440000000",
    "number": "1861284895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2335 S I ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984053816",
            "telephone_number": "206-326-8122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2335 S I ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984053816",
            "telephone_number": "206-326-8122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE FUNCTIONAL HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-17",
        "last_updated": "2025-05-17",
        "certification_date": "2025-05-17",
        "status": "A",
        "authorized_official_last_name": "MANIAGO",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "NURSE PRACTITIONER/OWNER",
        "authorized_official_telephone_number": "206-326-8122",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "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 May 17, 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.