Individual provider Active NPI

Miranda Holly Marti, N.D., L.AC.

  • Naturopath
  • Kirkland, WA
National Provider Identifier
1962737809
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
NaturopathTaxonomy code 175F00000X
License
NT60105841 Issued in WA
Practice address
12815 120TH Ave NE Ste E
Kirkland, WA 98034-3003
Phone
(425) 398-9355
Fax
(425) 453-2827
NPI assigned
Oct 9, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Naturopath 175F00000X NT60105841 WA Primary
Acupuncturist 171100000X AC60105885 WA

Addresses

Primary practice location

12815 120TH Ave NE Ste E
Kirkland, WA 98034-3003

Mailing address

1135 116TH Ave NE Ste 620
Bellevue, WA 98004-4636
Phone (425) 454-8016

Other identifiers 1

IdentifierTypeStateIssuer
2035068MedicaidWA

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
AC60105885WAMDAcupuncturist
NT60105841WAMDNaturopath

NPI Registry JSON

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

{
    "created_epoch": "1255046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1962737809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 116TH AVE NE STE 620",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980044636",
            "telephone_number": "425-454-8016",
            "fax_number": "425-453-2827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12815 120TH AVE NE STE E",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343003",
            "telephone_number": "425-398-9355",
            "fax_number": "425-453-2827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTI",
        "first_name": "MIRANDA",
        "middle_name": "HOLLY",
        "name_prefix": "Mrs.",
        "credential": "N.D., L.AC.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-09",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "WA",
            "license": "NT60105841",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "WA",
            "license": "AC60105885",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2035068",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.