Individual provider Active NPI

Sadie Lira

  • Specialist
  • Vancouver, WA
National Provider Identifier
1912357294
Registry record updated Jun 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA60317746 Issued in WA
Practice address
11516 SE Mill Plain Blvd Ste 2C
Vancouver, WA 98684-5082
Phone
(360) 253-6674
NPI assigned
Jun 16, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA60317746 WA Primary

Addresses

Primary practice location

11516 SE Mill Plain Blvd Ste 2C
Vancouver, WA 98684-5082

Mailing address

11516 SE Mill Plain Blvd Ste 2C
Vancouver, WA 98684-5082
Phone (360) 253-6674

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
MA60317746WAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Michael B. Pettet, DC, PS PastSince Jan 30, 2016 Accepting new patients

Organizations & group practices 1

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": "1466035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466035200000",
    "number": "1912357294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11516 SE MILL PLAIN BLVD STE 2C",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986845082",
            "telephone_number": "360-253-6674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11516 SE MILL PLAIN BLVD STE 2C",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986845082",
            "telephone_number": "360-253-6674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIRA",
        "first_name": "SADIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-16",
        "last_updated": "2016-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA60317746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2016; 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.