Mercedes Marie Alice, ARNP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Kenmore, WA
NPI 1033475348 · NPPES record last updated Sep 25, 2024
Key facts
- NPI
- 1033475348
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- AP60425457 (WA)
- Practice address
- 18208 66TH Ave NE Ste 201
Kenmore, WA 98028 - Phone
- (425) 814-2045
- Fax
- (425) 814-2783
- NPI assigned
- Apr 11, 2012
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP60425457 | WA | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ebb and Flow Mental Health, PLLC | Current | Accepting new patients |
Locations
100 N Howard St
Spokane, WA 99201
Phone (206) 201-1163
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | AP60425457 | WA | Yes |
| Psychiatric/Mental Health Registered Nurse | 163WP0808X | RN60022966 | WA |
Addresses
Primary practice location
18208 66TH Ave NE Ste 201
Kenmore, WA 98028
Mailing address
18208 66TH Ave NE Ste 201
Kenmore, WA 98028-7949
Phone (425) 814-2045
Other practice location 1
100 N Howard St Ste W
Spokane, WA 99201-0508
Phone (425) 615-6696
Other providers in Kenmore, WA
- Peimaneh Abdolhosseini
- Abigail Desjardien, M.a. CCC-SLP, LLC
- Aim 2 Nourish, LLC
- Duaa Al-Jassim
- Mikaela Noel Aldaco-Fowler
- Amenity Home Health Care, Inc
- Amin Tabatabaian DDS PLLC
- Anthony Paul Amos
- Timothy Scott Anderson
- Andrew Ensor Counseling, PLLC
All providers in Kenmore, WA · Psychiatric/Mental Health Nurse Practitioner in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 25, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.