Individual provider Active NPI

Salome Mosses, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Kirkland, WA
National Provider Identifier
1013675883
Registry record updated Jun 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP61301494 Issued in WA
Practice address
11335 NE 122ND Way Ste 105
Kirkland, WA 98034-6933
Phone
(781) 248-8996
NPI assigned
Nov 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 70213 ID
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN2304305 MA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1058998 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP61301494 WA Primary

Addresses

Primary practice location

11335 NE 122ND Way Ste 105
Kirkland, WA 98034-6933

Mailing address

PO Box 262351
Plano, TX 75026-2351

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
70213IDMDPsychiatric/Mental Health Nurse Practitioner
RN2304305MAMDPsychiatric/Mental Health Nurse Practitioner
1058998TXMDPsychiatric/Mental Health Nurse Practitioner
AP61301494WAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Kathleen Worsley PastSince Oct 4, 2023 Accepting new patients

Organizations & group practices 1

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": "1638144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686009600000",
    "number": "1013675883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 262351",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750262351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11335 NE 122ND WAY STE 105",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980346933",
            "telephone_number": "781-248-8996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSSES",
        "first_name": "SALOME",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-29",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ID",
            "license": "70213",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2304305",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1058998",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61301494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2023; 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.