Liberty Dialysis - Sacramento LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

LIBERTY DIALYSIS - SACRAMENTO LLC

Doing business as

Liberty Dialysis - Manzanita

Practice address

1127 Broadway
Suite 202
Tacoma, WA 98402-3519

Phone

(206) 236-5001

NPI assigned

Mar 10, 2008

Organization subpart

No

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

Authorized official

Name

Ryan B Pardo

Title

Vice President

Phone

(206) 236-5001

Specialties & licenses 1

Addresses

Other names 1

• Liberty Dialysis - Manzanita Doing business as

Tax ID family

Liberty Dialysis - Manzanita2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Liberty Dialysis - Sacramento LLC

  dba Liberty Dialysis - South Sacramento

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Mercer Island, WA
  • NPI 1649440363
  NPD tax ID

Locations

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

{
    "created_epoch": "1205107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205107200000",
    "number": "1952571689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1127 BROADWAY",
            "address_2": "SUITE 202",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984023519",
            "telephone_number": "206-236-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1127 BROADWAY",
            "address_2": "SUITE 202",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984023519",
            "telephone_number": "206-236-5001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY DIALYSIS - SACRAMENTO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-10",
        "last_updated": "2008-03-10",
        "status": "A",
        "authorized_official_last_name": "PARDO",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "206-236-5001"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Liberty Dialysis - Manzanita",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Yi Ran Li, PT, DPT
• Claire B. Liau, D.D.S.
• Liberating Jasper LLC
• Liberation Therapy PLLC
• Liberty Dialysis - Laredo Acutes LLC
• Tamar Libicki
• Matthew Libid, CRNA
• Jacqueline Licea
• Alexandrea Ann Liddell, LPN
• Donna May Lidren, PHD

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Tacoma, WA
• Providers in Tacoma, WA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2008; 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.