Active NPI
Makiatu Pratt
- Phlebology Physician
- Kent, WA
National Provider Identifier
1992481592
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Phlebology Physician
- License
- 202K00000X
- Practice address
- 24817 112TH Ave SE
Kent, WA 98030-6610 - Phone
- (253) 653-9107
- NPI assigned
- Jun 27, 2023
- 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 |
|---|---|---|---|---|
| Phlebology Physician | 202K00000X | 202K00000X | WA | Primary |
Addresses
Primary practice location
24817 112TH Ave SE
Kent, WA 98030-6610
Mailing address
PO Box 5354
Kent, WA 98064-5354
Phone (253) 653-9107
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 |
|---|---|---|---|
| 202K00000X | WA | MD | Phlebology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687824000000",
"number": "1992481592",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5354",
"city": "KENT",
"state": "WA",
"postal_code": "980645354",
"telephone_number": "253-653-9107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24817 112TH AVE SE",
"city": "KENT",
"state": "WA",
"postal_code": "980306610",
"telephone_number": "253-653-9107"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRATT",
"first_name": "MAKIATU",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-06-27",
"last_updated": "2023-06-27",
"certification_date": "2023-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "202K00000X",
"taxonomy_group": "",
"desc": "Phlebology",
"state": "WA",
"license": "202K00000X",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kent, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.