LEE A ANTLES (NPI# 1811995525) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811995525 |
| Entity Type | Individual |
| Full Name | LEE A ANTLES |
| Credential | MD |
| Practice Address |
9040 Jackson Avenue Tacoma WA 98431-8151 |
| Mailing Address |
9040 Jackson Avenue Tacoma WA 98431-0001 |
| Practice Telephone | 2539682462 |
| Mailing Telephone | 2539682462 |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2019-03-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | MD00025946 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | LABOR & INDUSTRIES | 0168090 | 01 |
| RAILROAD MEDICARE UPIN | 110245917 | 01 | |
| MEDICARE PTAN | GAB34522 | 01 |
| Street Address |
9040 JACKSON AVENUE |
| City | TACOMA |
| State | WA |
| Zip Code | 98431-8151 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770117640 | Ryan Bradley Liberg | Student in an Organized Health Care Education/Training Program | 9040 Jackson Avenue, Tacoma, WA 98431-0001 | 2020-02-28 |
| 1255965588 | Travis Dunn | Student in an Organized Health Care Education/Training Program | 9040 Jackson Avenue, Tacoma, WA 98431-0001 | 2020-02-25 |
| 1538792023 | Christopher Hodge | Student in an Organized Health Care Education/Training Program | 9040 Jackson Avenue, Tacoma, WA 98431-0001 | 2020-02-13 |
| 1689206187 | Joscelyn Eva Hodge | Student in an Organized Health Care Education/Training Program | 9040 Jackson Avenue, Tacoma, WA 98431-0001 | 2020-02-12 |
| 1770115719 | Michael W Patt | Student in an Organized Health Care Education/Training Program | 9040 Jackson Avenue, Tacoma, WA 98431-0001 | 2020-02-07 |
| 1780228973 | Christopher Conner | Physician Assistant | 9040 Jackson Avenue, Tacoma, WA 98431-0001 | 2019-10-31 |
| 1417500638 | Eugenia Ann Haley | Social Worker | 9040 Jackson Avenue, Tacoma, WA 98431-1072 | 2019-07-17 |
| 1811556269 | Erika May | Registered Nurse | 9040 Jackson Avenue, Tacoma, WA 98431-0001 | 2019-06-10 |
| 1417510330 | Margaret Jayne Ramsdell | Case Manager/Care Coordinator | 9040 Jackson Avenue, Tacoma, WA 98431-0001 | 2019-04-16 |
| 1114486222 | Catherine Vaccaro | Dietitian, Registered | 9040 Jackson Avenue, Tacoma, WA 98431-0001 | 2019-03-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497212260 | Catrina Renee Grugin | Registered Nurse | Madigan Army Medical Center, Attn Mchj-clq-c, 9040 Jackson Ave, Tacoma, WA 98431 | 2019-02-27 |
| 1801307681 | Bianca Gomez | Dental Assistant | Bldg 9900 Lincoln Street, Jblm, WA 98431 | 2017-10-19 |
| 1184133225 | Darren Paris | Registered Nurse | Madigan Army Medical Center 9040 Jackson Ave., Attn: Mchj-clq-c, Tacoma, WA 98431 | 2017-09-20 |
| 1922538206 | Sarah Frerichs | Dentist | Madigan Annex, Second Floor, Bldg. 9900, Apo, AA 98431 | 2017-06-19 |
| 1740736495 | Misty Hill | Dental Assistant | 9119 Mill Park Ave, Tacoma, WA 98431 | 2016-08-31 |
| 1336695535 | Jacqueline D Massouda | Dentist | Jblm Dentac, 9900 Lincoln Sreet, 2nd Floor, Apo, AA 98431 | 2016-08-28 |
| 1609239375 | Gregg V Palmer | Licensed Practical Nurse | 17th and C Street, Bldg 11582, Tacoma, WA 98431 | 2016-03-31 |
| 1114323904 | Deanna Sheets | Nurse Practitioner | 911 Mil Park Ave, Tacoma, WA 98431 | 2014-11-06 |
| 1679905434 | Austin William Schaar | Dentist | Building 9900, 2nd Floor, Tacoma, WA 98431 | 2013-08-05 |
| 1518209758 | Maurice Ibrahim Khayat | Internal Medicine | 9040 Jackson Ave Mche-qd (creds), Tacoma, WA 98431 | 2013-03-26 |
| Find all providers in zip 98431 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730718628 | Brendan Eugene Raney | Internal Medicine | 202 N Borough Rd, Tacoma, WA 98403-2804 | 2020-04-03 |
| 1609404136 | Abigail Anne Cano Deleon | Internal Medicine | 4252 E Roosevelt Ave, Tacoma, WA 98404-4658 | 2020-03-30 |
| 1528691706 | Blue Med Inc. | Internal Medicine | 1222 N Sunset Dr, Tacoma, WA 98406-1027 | 2020-02-17 |
| 1417441189 | Iora Senior Health, Inc | Internal Medicine | 5006 Center St Ste R, Tacoma, WA 98409-2314 | 2018-06-18 |
| 1023525698 | Comprehensive Postacute Care Pllc | Internal Medicine | 1724 Pointe Woodworth Dr Ne, Tacoma, WA 98422-3480 | 2018-01-04 |
| 1972034494 | Brian Hagan | Internal Medicine | 1717 S. J. Street, Suite 336, S. Pavilion, Ms 01-30, Tacoma, WA 98405 | 2017-03-26 |
| 1184967242 | Jerry Hu | Internal Medicine | 415 6th Ave Unit 505, Tacoma, WA 98402-2310 | 2013-03-27 |
| 1639426232 | Desiree Marie Lehmann | Internal Medicine | 1717 S J St # Ms 01-36, Tacoma, WA 98405-4933 | 2012-08-14 |
| 1720344617 | Don Nguyen | Internal Medicine | 1201 Pacific Ave Ste 1950, Tacoma, WA 98402 | 2012-04-05 |
| 1437445855 | Alexander A Divin | Internal Medicine | 1717 South J Street Suite 336, South Pavillion, Ms 01-30, Tacoma, WA 98405 | 2011-06-23 |
| Find all providers in TACOMA | ||||
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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.