NPI |
1023479532 |
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number. |
Entity Type Code |
1 |
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number. |
Provider Last Name Legal Name |
CLOUD |
The country code in the location address of the provider being identified. |
Provider First Name |
LORISSA |
The fax number associated with the location
address of the provider being identified. |
Provider Credential Text |
C.D.P. |
The middle name of the provider, if the provider
is an individual. |
Provider First Line Business Practice Location Address |
758 ST HELENS AVE |
Code designating the provider type, classification,
and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1. |
Provider Business Practice Location Address City Name |
TACOMA |
The city name in the location address of the provider being identified. |
Provider Business Practice Location Address State Name |
WA |
The State code in the location of the provider
being identified. |
Provider Business Practice Location Address Postal Code |
984023706 |
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. |
Provider Business Practice Location Address Country Code If outside U S |
US |
The country code in the location address of the provider being identified. |
Provider Business Practice Location Address Telephone Number |
2532740484 |
The telephone number associated with the location address of the provider being identified. |
Provider Enumeration Date |
3/10/2016 |
The date the provider was assigned a unique identifier (assigned an NPI). |
Last Update Date |
3/10/2016 |
The State code in the location of the provider
being identified. |
Provider Gender Code |
F |
The code designating the provider’s gender if the provider is a person. |
Healthcare Provider Taxonomy Code 1 |
101YA0400X |
Code designating the provider type, classification,
and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1. |
Provider License Number 1 |
60483171 |
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. |
Provider License Number State Code 1 |
WA |
The country code in the location address of the provider being identified. |
Healthcare Provider Primary Taxonomy Switch 1 |
Y |
Code indicating the type of identifier currently
or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form. |
Is Sole Proprietor |
N |
The date the provider was assigned a unique identifier (assigned an NPI). |