MR. MANUEL MIRANDA LATA JR. (NPI# 1386135895) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386135895 |
| Entity Type | Individual |
| Full Name | MR. MANUEL MIRANDA LATA JR. |
| Credential | RN |
| Practice Address |
505 29th St Se Auburn WA 98002-7541 |
| Mailing Address |
6400 Southcenter Blvd Tukwila WA 98188-2547 |
| Practice Telephone | 2538767650 |
| Practice Fax Number | 2063022210 |
| Mailing Telephone | 2069012000 |
| Mailing Fax Number | 2069012010 |
| Enumeration Date | 2018-05-21 |
| Last Update Date | 2018-05-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WP0808X |
Registered Nurse Specialization: Psych/Mental Health |
RN60680518 | WA | Nursing Service Providers |
| Street Address |
505 29TH ST SE |
| City | AUBURN |
| State | WA |
| Zip Code | 98002-7541 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821159740 | Dixie Masnov | Counselor | 505 29th St Se, Auburn, WA 98002-7541 | 2006-12-13 |
| 1356965065 | Patrick Diallo | Counselor | 505 29th St Se, Auburn, WA 98002-7541 | 2020-05-29 |
| 1336701523 | Estrella Asuncion Domingo | Counselor | 505 29th St Se, Auburn, WA 98002-7541 | 2019-07-08 |
| 1053971234 | Sound | Community Based Residential Treatment Facility, Mental Illness | 505 29th St Se, Auburn, WA 98002-7541 | 2019-06-19 |
| 1376107987 | Arleen Susan Chavez | Licensed Practical Nurse | 505 29th St Se, Auburn, WA 98002-7541 | 2019-04-29 |
| 1801450424 | Isaac Ngugi | Licensed Practical Nurse | 505 29th St Se, Auburn, WA 98002-7541 | 2019-04-29 |
| 1104380724 | Winifred Nandawula | Counselor | 505 29th St Se, Auburn, WA 98002-7541 | 2019-01-28 |
| 1164996773 | Jazmine Trevino | Counselor | 505 29th St Se, Auburn, WA 98002 | 2019-01-16 |
| 1801360789 | Collette Anjorie Brackett | Counselor | 505 29th St Se, Auburn, WA 98002-7541 | 2019-01-14 |
| 1902376940 | David Hyuk Kim | Registered Nurse | 505 29th St Se, Auburn, WA 98002-7541 | 2018-12-03 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336756451 | Natalia Marquez Avalos | Interpreter | 1001 37th St Se, Apt 2, Auburn, WA 98002 | 2020-09-24 |
| 1871065607 | Carrie Ann Sasser | Registered Nurse | 1005 37th Street Se, Auburn, WA 98002 | 2018-12-18 |
| 1730658881 | Nataliya Guga | Physical Therapy Assistant | 1323 17th St Se Apt A, Auburn, WA 98002 | 2018-11-19 |
| 1952876294 | Modeline Jules | Nurse Practitioner | 125 3rd St Ne Ste 403, Auburn, WA 98002 | 2018-10-12 |
| 1679055941 | Stephanie Storm Lariccia | Social Worker | 1000 Auburn Way S., Auburn, WA 98002 | 2018-09-04 |
| 1104330349 | North Auburn Health, LLC | Skilled Nursing Facility | 2830 I Street Ne, Auburn, WA 98002 | 2017-11-27 |
| 1265950554 | Allison Ortwein | Occupational Therapist | 2830 I St. Ne, Auburn, WA 98002 | 2017-09-06 |
| 1184171167 | Emily Faber | Counselor | 505 29th St, Auburn, WA 98002 | 2016-09-07 |
| 1255887907 | Elaine Priscilla Lucas | Counselor | 29th St Se Chartley House, 505, Auburn, WA 98002 | 2016-08-31 |
| 1871955823 | Melissa Mae Gustafson | Massage Therapist | 4220 A. St. Se, Suite 103, Auburn, WA 98002 | 2016-03-28 |
| Find all providers in zip 98002 | ||||
| Taxonomy Code | 163WP0808X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467740183 | Michael Smith | Registered Nurse | 10 Barton Ave, Auburn, ME 04210-6707 | 2011-07-15 |
| 1114033149 | Sarah Leah Blum | Registered Nurse | 303 O St Ne, Auburn, WA 98002-4645 | 2006-08-22 |
| 1093316796 | Jamie Dawn Bannister | Registered Nurse | 317 Turner St, Auburn, ME 04210-6038 | 2020-11-08 |
| 1073096277 | Michael William Deforrest | Registered Nurse | 146 North St, Auburn, NY 13021-3543 | 2018-09-13 |
| 1568838829 | Janine Cade Torres | Registered Nurse | 2704 I St Ne, Auburn, WA 98002-2411 | 2015-08-20 |
| 1437594165 | Symone Larisa Edwards | Registered Nurse | 505 29th St Se, Chartley House, Auburn, WA 98002-7541 | 2013-05-08 |
| 1104197763 | Veerpall Kaur Gill | Registered Nurse | 505 29th St Se, Chartley House, Auburn, WA 98002-7541 | 2012-01-13 |
| 1679879191 | Mercy Mandac Lazo | Registered Nurse | 505 29th St Se, Chartley House, Auburn, WA 98002-7541 | 2011-01-31 |
| 1245433242 | Laura Lee Trevino | Registered Nurse | 505 29th St Se, Chartley House, Auburn, WA 98002-7541 | 2007-06-07 |
| 1699814921 | Sandra M Cain | Registered Nurse | 2704 I St Ne, Auburn, WA 98002-2411 | 2007-02-05 |
| Find all providers in AUBURN | ||||
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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.