Active NPI
Kelly Thomas
- Licensed Practical Nurse
- University Place, WA
National Provider Identifier
1942090451
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- LP00059430
- Practice address
- 2901 Bridgeport Way W
University Place, WA 98466-4614 - Phone
- (253) 241-4176
- NPI assigned
- May 8, 2025
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | LP00059430 | WA | Primary |
Addresses
Primary practice location
2901 Bridgeport Way W
University Place, WA 98466-4614
Mailing address
15324 68TH Avenue CT E
Puyallup, WA 98375-7121
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 |
|---|---|---|---|
| LP00059430 | WA | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1746662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1746662400000",
"number": "1942090451",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15324 68TH AVENUE CT E",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983757121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2901 BRIDGEPORT WAY W",
"city": "UNIVERSITY PLACE",
"state": "WA",
"postal_code": "984664614",
"telephone_number": "253-241-4176"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "KELLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-05-08",
"last_updated": "2025-05-08",
"certification_date": "2025-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "WA",
"license": "LP00059430",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in University Place, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 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.