Individual provider Active NPI

Leticia Rodriguez, ARNP

  • Pediatric Nurse Practitioner
  • Yakima, WA
National Provider Identifier
1003471046
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
AP60961165 Issued in WA
Practice address
402 S 12TH Ave
Yakima, WA 98902-3115
Phone
(509) 575-0114
Fax
(509) 575-0808
NPI assigned
May 6, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X RN60326441 WA
Pediatric Nurse Practitioner 363LP0200X AP60961165 WA Primary

Addresses

Primary practice location

402 S 12TH Ave
Yakima, WA 98902-3115

Mailing address

3801 Kern Way
Yakima, WA 98902-6340
Phone (509) 574-3220

Other practice location 1

3801 Kern Way
Yakima, WA 98902-6340
Phone (509) 574-3220

Other identifiers 1

IdentifierTypeStateIssuer
233416MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190711002465 WA Practitioner - Nurse Practitioner 3173858289 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP60961165WAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Seattle Childrens Hospital CurrentSince Jan 16, 2022 Accepting new patients
Seattle Children'S Hospital CurrentSince Jan 16, 2022 Accepting new patients
The Association of Chrmc and University Physicians CurrentSince Feb 2, 2022 Accepting new patients
Yakima Valley Memorial Physicians CurrentSince Aug 12, 2025 Accepting new patients
Association of CHMC and University Physicians CurrentSince Feb 2, 2022 Accepting new patients
Yakima Valley Memorial Physicians CurrentSince Aug 12, 2025 Accepting new patients
Community Health of Central Washington CurrentSince Feb 27, 2023 Accepting new patients
Community Health of Central Washington CurrentSince Feb 27, 2023 Accepting new patients

Locations

1035 116th Ave NE
Bellevue, WA 98004
Phone (425) 451-4141

900 Pacific Ave
Ste 100
Everett, WA 98201
Phone (425) 304-6080

8232 W Grandridge Blvd
Kennewick, WA 99336
Phone (509) 582-1700

4800 Sand Point Way NE
Seattle, WA 98105
Phone (206) 526-2000

1780 NW Myhre Rd
Ste 2120
Silverdale, WA 98383
Phone (360) 782-3100

501 S 5th Ave
Yakima, WA 98902
Phone (509) 494-6700

3801 Kern Rd
Yakima, WA 98902
Phone (509) 574-3200

2811 Tieton Dr
Yakima, WA 98902
Phone (509) 249-5210

1806 W Lincoln Ave
Yakima, WA 98902
Phone (509) 452-4520

402 S 12th Ave
Yakima, WA 98902
Phone (509) 248-3263

Interoperability endpoints

  • Direct secure messaging: lrodriguez29702@yvfwc.direct-ci.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1557100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1003471046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 KERN WAY",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989026340",
            "telephone_number": "509-574-3220",
            "fax_number": "509-574-3211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 S 12TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023115",
            "telephone_number": "509-575-0114",
            "fax_number": "509-575-0808"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3801 Kern Way",
            "address_purpose": "LOCATION",
            "city": "Yakima",
            "state": "WA",
            "postal_code": "989026340",
            "country_code": "US",
            "telephone_number": "509-574-3220",
            "fax_number": "509-574-3211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "LETICIA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-06",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WA",
            "license": "RN60326441",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WA",
            "license": "AP60961165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "233416",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.