Individual provider Active NPI

Martha Moeonono Laumoli, BA

  • Psychiatric Residential Treatment Facility
  • Tacoma, WA
National Provider Identifier
1932488004
Registry record updated Aug 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X
License
CG60215106 Issued in WA
Practice address
1201 S Proctor St
Tacoma, WA 98405-2047
Phone
(253) 396-5937
Fax
(253) 566-2252
NPI assigned
Aug 8, 2011
Last updated
Aug 8, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Residential Treatment Facility 323P00000X CG60215106 WA Primary

Addresses

Primary practice location

1201 S Proctor St
Tacoma, WA 98405-2047

Mailing address

1201 S Proctor St
Tacoma, WA 98405-2047
Phone (253) 396-5937

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
Bachelor of Arts

State licenses

LicenseStateTypeSpecialty
CG60215106WAMDPsychiatric Residential Treatment Facility

NPI Registry JSON

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

{
    "created_epoch": "1312761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312761600000",
    "number": "1932488004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 S PROCTOR ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984052047",
            "telephone_number": "253-396-5937",
            "fax_number": "253-566-2252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 S PROCTOR ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984052047",
            "telephone_number": "253-396-5937",
            "fax_number": "253-566-2252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUMOLI",
        "first_name": "MARTHA",
        "middle_name": "MOEONONO",
        "name_prefix": "Ms.",
        "credential": "BA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-08",
        "last_updated": "2011-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "WA",
            "license": "CG60215106",
            "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 Aug 8, 2011; 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.