DR. DOUGLAS DARREN PRESTA (NPI# 1669463519) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669463519 |
| Entity Type | Individual |
| Full Name | DR. DOUGLAS DARREN PRESTA |
| Credential | DPM |
| Practice Address |
4361 Talbot Rd S Suite 101 Renton WA 98055-6226 |
| Practice Telephone | 4253364442 |
| Practice Fax Number | 4252711368 |
| Mailing Telephone | 4253364442 |
| Mailing Fax Number | 4252711368 |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 213EP1101X |
Podiatrist Specialization: Primary Podiatric Medicine |
0196005 | WA | Podiatric Medicine & Surgery Service Providers |
| X | 213ES0000X |
Podiatrist Specialization: Sports Medicine |
0196005 | WA | Podiatric Medicine & Surgery Service Providers |
| X | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
0196005 | WA | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | WORKERS COMP GRP # | 0056910 | 01 |
| WA | REGENCE | 1597PR | 01 |
| WA | REGENCE GROUP # | VA5229 | 01 |
| WA | WORKERS COMP | 0196005 | 01 |
| WA | 8274391 | 05 | |
| WA | CIGNA MEDICARE | 0293820001 | 01 |
| Street Address |
4361 TALBOT RD S SUITE 101 |
| City | RENTON |
| State | WA |
| Zip Code | 98055-6226 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528068533 | Renton Sports & Spine Pt | Physical Therapist | 4361 Talbot Rd S, Suite 100, Renton, WA 98055-6226 | 2005-08-01 |
| 1568875789 | Proliance Surgeons, Inc., P.s. | Orthopaedic Surgery | 4361 Talbot Rd S, Suite 102, Renton, WA 98055-6226 | 2014-06-05 |
| 1063725505 | David P Ruoff, Md, Inc, Ps. | Orthopaedic Surgery | 4361 Talbot Rd S, Suite 102, Renton, WA 98055-6226 | 2010-07-26 |
| 1043490543 | Associated Valley Providers Pllc | Obstetrics & Gynecology | 4361 Talbot Rd S, Suite 112, Renton, WA 98055-6226 | 2007-11-13 |
| 1356541882 | Children First Pediatrics, Pllc | Clinic/Center | 4361 Talbot Rd S, Suite 103, Renton, WA 98055-6226 | 2007-07-23 |
| 1841352143 | Orit Hickman | Specialist | 4361 Talbot Rd S, Ste 100, Renton, WA 98055-6226 | 2006-12-14 |
| 1578623690 | John L Vander Heyden | Obstetrics & Gynecology | 4361 Talbot Rd S, 112, Renton, WA 98055-6226 | 2006-12-11 |
| 1336208321 | Michael Brian Vickers | Podiatrist | 4361 Talbot Rd S, 112, Renton, WA 98055-6226 | 2006-12-06 |
| 1447319330 | Mary Louise Mckevitt | Registered Nurse | 4361 Talbot Rd S, Renton, WA 98055-6226 | 2006-12-06 |
| 1063584498 | Deborah Jean Ketterer | Podiatrist | 4361 Talbot Rd S, Suite 101, Renton, WA 98055-6226 | 2006-11-14 |
| Find all providers in the same location | ||||
| 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 | 213EP1101X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Primary Podiatric Medicine |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982694501 | Michael Aziz Mishalanie | Podiatrist | 401 S 43rd St, Suite 110, Renton, WA 98055-5404 | 2005-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649708819 | Theresa H.t. Nguyen Pllc | Podiatrist | 17530 Ne Union Hill Rd Ste 110, Redmond, WA 98052-3340 | 2017-05-31 |
| 1366749095 | Rapha Clinics, Inc | Podiatrist | 1130 N 185th St Ste 202, Shoreline, WA 98133-4011 | 2011-02-15 |
| 1568673895 | Victoria Kovacs Penfield | Podiatrist | 15717 136th Avenue Ct E, Puyallup, WA 98374-9688 | 2007-05-25 |
| 1922122811 | Randall S. Fisher | Podiatrist | 8610 Eastview Ave, Everett, WA 98208-3516 | 2007-03-18 |
| 1689732588 | Hugh James Gorey Jr. | Podiatrist | 12001 Pacific Ave S., #204, Tacoma, WA 98444-5101 | 2006-12-04 |
| 1134154032 | Stephen Haggard | Podiatrist | 210 27th Ave Apt F105, Milton, WA 98354-8330 | 2006-07-11 |
| 1265470678 | Broadway Foot & Ankle Ps | Podiatrist | 6625 W Crest View Loop Se, Snoqualmie, WA 98065-8912 | 2006-06-04 |
| 1063493559 | Randolph Charles Fish | Podiatrist | 915 So. 76th St., Tacoma, WA 98408-2902 | 2005-11-10 |
| 1942206891 | Brent Barker | Podiatrist | 18007 Ne 26th St, Vancouver, WA 98684-0735 | 2005-06-24 |
| 1720083652 | John Yohan Joo | Podiatrist | 1130 N 185th St, Suite 200, Shoreline, WA 98133-4011 | 2005-06-16 |
| Find all providers with the same taxonomy | ||||
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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.