Individual provider Active NPI

Edwin Mwatha

  • Registered Nurse
  • Auburn, WA
National Provider Identifier
1013454594
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN60296875 Issued in WA
Practice address
505 29TH St SE
Auburn, WA 98002-7541
Phone
(253) 876-7650
Fax
(253) 876-7651
NPI assigned
Jan 23, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN60296875 WA Primary

Addresses

Primary practice location

505 29TH St SE
Auburn, WA 98002-7541

Mailing address

1600 E Olive St
Sound Mental Health
Seattle, WA 98122-2735
Phone (206) 302-2200

Other practice location 1

107 S Division St
Spokane, WA 99202-1510
Phone (509) 838-4651

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RN60296875WAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Past Accepting new patients
Sound Past Accepting new patients

Organizations & group practices 2

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": "1485129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1013454594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 E OLIVE ST",
            "address_2": "SOUND MENTAL HEALTH",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981222735",
            "telephone_number": "206-302-2200",
            "fax_number": "206-302-2210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 29TH ST SE",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980027541",
            "telephone_number": "253-876-7650",
            "fax_number": "253-876-7651"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "107 S Division St",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992021510",
            "country_code": "US",
            "telephone_number": "509-838-4651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MWATHA",
        "first_name": "EDWIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-23",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60296875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.