DESIREE FREDERICKS (NPI# 1700365152) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700365152 |
| Entity Type | Individual |
| Full Name | DESIREE FREDERICKS |
| Practice Address |
723 Martin Luther King Jr Way Tacoma WA 98405-4139 |
| Practice Telephone | 2533834447 |
| Enumeration Date | 2018-08-07 |
| Last Update Date | 2018-08-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 222Z00000X | Orthotist | 952667855 | WA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 224P00000X | Prosthetist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
723 MARTIN LUTHER KING JR WAY |
| City | TACOMA |
| State | WA |
| Zip Code | 98405-4139 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649381534 | Hanger Prosthetics & Orthotics West, Inc | Durable Medical Equipment & Medical Supplies | 723 Martin Luther King Jr Way, Tacoma, WA 98405-4139 | 2006-08-31 |
| 1336612753 | Richard Rex Marin | Orthotist | 723 Martin Luther King Jr Way, Tacoma, WA 98405-4139 | 2019-01-08 |
| 1962775205 | Scott Michael Holm | Orthotist | 723 Martin Luther King Jr Way, Tacoma, WA 98405-4139 | 2012-02-16 |
| 1811294598 | Jennifer Muir | Orthotist | 723 Martin Luther King Jr Way, Tacoma, WA 98405-4139 | 2011-02-16 |
| 1740412808 | Joseph Frederick Eads | Orthotic Fitter | 723 Martin Luther King Jr Way, Tacoma, WA 98405-4139 | 2009-08-21 |
| 1154553204 | Sara Elizabeth Heiberg | Orthotist | 723 Martin Luther King Jr Way, Tacoma, WA 98405-4139 | 2009-08-21 |
| 1619128170 | Brian C Roehr | Orthotist | 723 Martin Luther King Jr Way, Tacoma, WA 98405-4139 | 2008-10-02 |
| 1730370073 | Eric L Weber | Orthotist | 723 Martin Luther King Jr Way, Tacoma, WA 98405-4139 | 2007-08-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609486026 | Joanna Christine Hope | Physician Assistant | 2502 S Union Avenue, Tacoma, WA 98405 | 2020-08-01 |
| 1467077891 | Richard Jimenez | Student in an Organized Health Care Education/Training Program | 1202 M.l.k. Jr Way Suite #310, Tacoma, WA 98405 | 2020-06-11 |
| 1669008785 | Mariana Sanchez Corona | Behavior Technician | 1901 S Union Ave Allenmore Building B, Tacoma, WA 98405 | 2020-03-20 |
| 1811534845 | Jasmine Gregory | Social Worker | 311 Martin Luther King Jr. Way, Ms:315-c2-php, Tacoma, WA 98405 | 2019-12-10 |
| 1548807506 | Holly Rebecca Brezynski | Student in an Organized Health Care Education/Training Program | Fresenius Kindney Care - Home Therapies Department, 1717 South J Street, Tacoma, WA 98405 | 2019-12-09 |
| 1972064392 | Logan Brau | Student in an Organized Health Care Education/Training Program | 1202 M.l.k. Jr Way, Tacoma, WA 98405 | 2019-03-28 |
| 1629532536 | Preferred Orthotic and Prosthetic Services Inc | Prosthetic/Orthotic Supplier | 1708 Yakima Ave Ste 60, Tacoma, WA 98405 | 2019-01-24 |
| 1669945911 | Heidi Weakley | Counselor | 1001 S Yakima Ave, Suite 5, Tacoma, WA 98405 | 2019-01-09 |
| 1972074011 | Taviance Benet Laster | Behavior Technician | 1416 S 9th St, Tacoma, WA 98405 | 2018-12-16 |
| 1336618040 | Bailey Bangerter | Physician Assistant | 1901 South Union, A-233, Tacoma, WA 98405 | 2018-11-26 |
| Find all providers in zip 98405 | ||||
| Taxonomy Code | 222Z00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Orthotist |
| A health care professional who is specifically educated and trained to manage comprehensive orthotic patient care, including musculoskeletal and neuromuscular anomalies resulting from injuries or disease processes involving the lower extremity, upper extremity or spinal segment/s and positional deformation of the cranium. Orthotists 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 |
|---|---|---|---|---|
| 1144669342 | Glen Pigman | Orthotist | 3612 S 11th St, Tacoma, WA 98405-2126 | 2013-06-20 |
| 1669613360 | Ben George | Orthotist | 1901 South Union Ave, #b-6007, Tacoma, WA 98405-1806 | 2009-03-10 |
| 1275779993 | Lizotte P & O Associates LLC | Orthotist | 1902 S Cedar St, Tacoma, WA 98405-2301 | 2008-12-30 |
| 1568520617 | Patricia Ann Kaviani | Orthotist | Mamc 9040 Fitsimmons Dr, Tacoma, WA 98431-1100 | 2006-12-04 |
| 1336612753 | Richard Rex Marin | Orthotist | 723 Martin Luther King Jr Way, Tacoma, WA 98405-4139 | 2019-01-08 |
| 1821530890 | Nathan Dooley | Orthotist | 1902 S Cedar St, Tacoma, WA 98405-2301 | 2016-11-08 |
| 1962775205 | Scott Michael Holm | Orthotist | 723 Martin Luther King Jr Way, Tacoma, WA 98405-4139 | 2012-02-16 |
| 1811294598 | Jennifer Muir | Orthotist | 723 Martin Luther King Jr Way, Tacoma, WA 98405-4139 | 2011-02-16 |
| 1154553204 | Sara Elizabeth Heiberg | Orthotist | 723 Martin Luther King Jr Way, Tacoma, WA 98405-4139 | 2009-08-21 |
| 1619128170 | Brian C Roehr | Orthotist | 723 Martin Luther King Jr Way, Tacoma, WA 98405-4139 | 2008-10-02 |
| 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.