JACOB ROBERT LYNN BRUBAKER (NPI# 1275880015) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1275880015 |
Entity Type | Individual |
Full Name | JACOB ROBERT LYNN BRUBAKER |
Credential | C.P.O. |
Practice Address |
17927 131st St E Bonney Lake WA 98391-7686 |
Mailing Address |
3400 Latouche St Suite 100 Anchorage AK 99508-4208 |
Practice Telephone | 2067903890 |
Mailing Telephone | 9075611777 |
Mailing Fax Number | 9075612157 |
Enumeration Date | 2012-08-10 |
Last Update Date | 2019-12-02 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 222Z00000X | Orthotist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
Y | 224P00000X | Prosthetist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AK | PO0012 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740433945 | Jacob Wellington Brubaker | Ophthalmology | 1515 River Park Dr Ste 100, Sacramento, CA 95815-4605 | 2008-10-31 |
Street Address |
17927 131ST ST E |
City | BONNEY LAKE |
State | WA |
Zip Code | 98391-7686 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1699313742 | Butler and Brubaker Orthotics and Prosthetics | Prosthetist | 17927 131st St E, Bonney Lake, WA 98391-7686 | 2019-12-18 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982218814 | Lenny Yann | Pharmacist | 21301 Wa 410, Bonney Lake, WA 98391 | 2020-09-08 |
1497244552 | Kayla Grasso | Technician, Other | 18444 139th Street East, Bonney Lake, WA 98391 | 2018-05-04 |
1407359151 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 9801 204th Ave E, Bonney Lake, WA 98391 | 2018-03-08 |
1992217152 | Rachel Renee Andringa | Massage Therapist | 19102 Wa-410, Bonney Lake, WA 98391 | 2017-10-27 |
1437679099 | Emily A. Hansen | Occupational Therapist | 12202 209th Ave Ct. E., Liberty Ridge Elementary School, Bonney Lake, WA 98391 | 2017-06-26 |
1245782986 | Advance Behavior Education Continuum, Inc | Behavioral Analyst | 2305 164th Ave Ct, Bonney Lake, WA 98391 | 2016-10-28 |
1619343191 | Lauren Christine Difolco | Specialist | 10920 199th Ave. Ct. E., Bonney Lake Hs, Bonney Lake, WA 98391 | 2015-08-19 |
1699018192 | Michael Nelson | Dentist | 2803 176th Ave East, Lake Tapps, WA 98391 | 2013-04-03 |
1700141066 | Jacqueline Nguyen | Pharmacist | 20025 State Route 410 E, Bonney Lake, WA 98391 | 2012-07-11 |
1265737860 | Braden Shingleton | Massage Therapist | 19102 Sr 410 E Suite A, Bonney Lake, WA 98391 | 2011-01-13 |
Find all providers in zip 98391 |
Taxonomy Code | 224P00000X |
Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Classification | Prosthetist |
A health care professional who is specifically educated and trained to manage comprehensive prosthetic patient care for individuals who have sustained complete or partial limb loss or absence. Prosthetists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care. |
Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1699313742 | Butler and Brubaker Orthotics and Prosthetics | Prosthetist | 17927 131st St E, Bonney Lake, WA 98391-7686 | 2019-12-18 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043785777 | Natalie Kirsten Harold | Prosthetist | 123 2nd Ave S Ste 200, Edmonds, WA 98020-8449 | 2018-10-09 |
1497129092 | Stevie Stephens | Prosthetist | 723 Mlk Jr Way, Tacoma, WA 98405 | 2015-11-19 |
1427243468 | Andrew J Lind | Prosthetist | 401 S Sherman St, Spokane, WA 99202-6001 | 2007-09-12 |
1508057845 | David M Kelly | Prosthetist | 1900 116th Ave Ne Ste 201, Bellevue, WA 98004-3013 | 2007-08-01 |
1093891616 | Virginias Feminine Boutique, LLC | Prosthetist | 3627 152nd St Ne, Marysville, WA 98271-8944 | 2006-10-27 |
1912081860 | American Artificial Limb Co | Prosthetist | 650 S Orcas St, Suite 100, Seattle, WA 98108-2654 | 2006-10-25 |
1487631586 | Michael Philip Podrasky | Prosthetist | 1420 4th St Se, Ste D, Puyallup, WA 98372 | 2005-12-29 |
1891394086 | Janae Christine Buchan | Prosthetist | 2621 Ne 134th St Ste 120, Vancouver, WA 98686-3036 | 2020-10-20 |
1164020426 | Sarah Mccarthy Cheever | Prosthetist | 4575 Sand Point Way Ne, Seattle, WA 98105-3950 | 2020-10-09 |
1720612450 | Sean C Hails | Prosthetist | 1901 S Cedar St Ste 202, Tacoma, WA 98405-2303 | 2020-03-03 |
Find all providers with the same taxonomy |
City | BONNEY LAKE |
Zip Code | 98391 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.