DERRICK BRIDGES (NPI# 1144435256) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144435256 |
| Entity Type | Individual |
| Full Name | DERRICK BRIDGES |
| Credential | LMP |
| Practice Address |
10622 Se Carr Rd Suite A Renton WA 98055-5824 |
| Practice Telephone | 4252772225 |
| Practice Fax Number | 4252771591 |
| Mailing Telephone | 4252772225 |
| Mailing Fax Number | 4252771591 |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | MA00020141 | WA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | L&I | 0191632 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003257411 | Derrick Bridges | Specialist/Technologist | 11200 Governor Manly Way, Raleigh, NC 27614-8599 | 2013-07-13 |
| Street Address |
10622 SE CARR RD SUITE A |
| City | RENTON |
| State | WA |
| Zip Code | 98055-5824 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467536656 | Jeffrey Scott Petett | Chiropractor | 10622 Se Carr Rd, Suite A, Renton, WA 98055-5824 | 2006-10-24 |
| 1457778334 | Samantha Holcomb | Massage Therapist | 10622 Se Carr Rd, Suite A, Renton, WA 98055-5406 | 2014-03-28 |
| 1962770461 | Michael J Ehrenheim | Chiropractor | 10622 Se Carr Rd, Suite A, Renton, WA 98055-5406 | 2011-12-12 |
| 1568743045 | Jennifer Rae Faline | Massage Therapist | 10622 Se Carr Rd, Suite A, Renton, WA 98055-5406 | 2011-08-29 |
| 1568640324 | Petett Chiropractic Clinic, Inc. | Clinic/Center | 10622 Se Carr Rd, Suite A, Renton, WA 98055-5406 | 2008-02-04 |
| 1548451099 | Gary Stephen Nixon | Specialist | 10622 Se Carr Rd, Suite A, Renton, WA 98055-5406 | 2007-08-08 |
| 1932226909 | Anne R Petett | Chiropractor | 10622 Se Carr Rd, Suite A, Renton, WA 98055-5824 | 2007-03-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356965750 | Proliance Surgery Center At Valley, LLC | Clinic/Center | 4009 Talbot Road S, Suite 200, Renton, WA 98055 | 2020-06-01 |
| 1851804959 | Talbot Rehabilitation Center, LLC | Skilled Nursing Facility | 4430 Talbot Road South, Renton, WA 98055 | 2017-11-10 |
| 1154878668 | Nelson Family Dentistry | Dentist | 19221 108th Ave Se Suite #2, Renton, WA 98055 | 2016-09-01 |
| 1598182990 | Annie Kyunga Ahn | Otolaryngology | 4033 Talbot Rd S Ste 540, Renton, WA 98055 | 2014-03-24 |
| 1376960138 | Madhuri Gordhan Patel | Registered Nurse | 3501 Mill Place South, Renton, WA 98055 | 2014-03-18 |
| 1912331042 | Karen Dohr | Pharmacist | 400 S. 43 Street, Renton, WA 98055 | 2013-08-26 |
| 1659637668 | Benjamin Reiss | Ophthalmology | 4300 Talbot Rd S Ste 300, Renton, WA 98055 | 2012-04-03 |
| 1205137940 | Duy Ai Quang Hoang | Pharmacist | 9431 S 196th Pl, Renton, WA 98055 | 2010-11-11 |
| 1972823664 | Erica L Ellzey | Physical Therapist | 18623 112th Ave Se, Renton, WA 98055 | 2010-06-04 |
| 1588984587 | Melissa A. Jordan | Nurse Anesthetist, Certified Registered | 4011 Talbot Rd., 5th Floor, Renton, WA 98055 | 2010-06-02 |
| Find all providers in zip 98055 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073940474 | Margarette Adelina Gagnon | Specialist | 110 Williams Ave S, Apt 305, Renton, WA 98057-5436 | 2013-09-30 |
| 1194150615 | Kelsey Maher | Specialist | 1208 Lincoln Pl Ne, Renton, WA 98056-2854 | 2013-09-04 |
| 1316216583 | Sarajane Priscilla Huff | Specialist | 2311 Ne 27th St, Renton, WA 98056-2234 | 2011-12-17 |
| 1699042358 | Tia Maumi Ballard | Specialist | 200 Sw 41st St Ste 100, Renton, WA 98057-4917 | 2011-11-23 |
| 1841589587 | Jennifer Marie Stoudt | Specialist | 318 Garden Ave N, Renton, WA 98057-5729 | 2011-04-04 |
| 1558668400 | Pain Associates of Washington Pllc | Specialist | 4300 Talbot Rd S Ste 200, Renton, WA 98055-6238 | 2011-02-11 |
| 1326340456 | Tabatha Burris | Specialist | 14410 Petrovistsky Rd Se #109, Renton, WA 98058 | 2010-11-22 |
| 1750536918 | Mitchael Gordon Welch | Specialist | 862 Aberdeen Ave Ne, Renton, WA 98056-2856 | 2008-12-01 |
| 1770746422 | Frank Fung Pllc | Specialist | 4033 Talbot Rd S Ste 430, Renton, WA 98055-5700 | 2008-07-02 |
| 1285812115 | Jennifer Loveless | Specialist | 19932 101st Ave Se, Renton, WA 98055-7306 | 2008-02-01 |
| Find all providers in RENTON | ||||
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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.