Active NPI
Phanya Pick, LMP
- Specialist
- Tacoma, WA
National Provider Identifier
1942642251
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 60079248
- Practice address
- 8002 Portland Ave E
Tacoma, WA 98404-3349 - Phone
- (253) 223-6267
- NPI assigned
- Jul 28, 2013
- Last updated
- Sep 14, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Specialist | 174400000X | 60079248 | WA | Primary |
Addresses
Primary practice location
8002 Portland Ave E
Tacoma, WA 98404-3349
Mailing address
958 101St Street CT E
Tacoma, WA 98445-3143
Phone (253) 682-9120
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 |
|---|---|---|---|
| 60079248 | WA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1374969600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442188800000",
"number": "1942642251",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "958 101ST STREET CT E",
"city": "TACOMA",
"state": "WA",
"postal_code": "984453143",
"telephone_number": "253-682-9120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8002 PORTLAND AVE E",
"city": "TACOMA",
"state": "WA",
"postal_code": "984043349",
"telephone_number": "253-223-6267"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PICK",
"first_name": "PHANYA",
"credential": "LMP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-07-28",
"last_updated": "2015-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WA",
"license": "60079248",
"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 Sep 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.