Lake Meridian Psychiatry PLLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

LAKE MERIDIAN PSYCHIATRY PLLC

Practice address

200 Auburn Ave Ste 3
Auburn, WA 98002-5015

Phone

(253) 397-7135

NPI assigned

Apr 24, 2023

Organization subpart

No

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

Authorized official

Name

Faduma Abdirahman Haji Ali, ARNPNPI 1073071437

Title

Owner

Phone

(253) 397-7135

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Faduma Abdirahman Haji Ali, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Bellevue, WA
  • NPI 1073071437
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1682294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682294400000",
    "number": "1033807532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 AUBURN AVE STE 3",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980025015",
            "telephone_number": "253-397-7135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 AUBURN AVE STE 3",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980025015",
            "telephone_number": "253-397-7135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE MERIDIAN PSYCHIATRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-24",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A",
        "authorized_official_last_name": "HAJI ALI",
        "authorized_official_first_name": "FADUMA",
        "authorized_official_middle_name": "ABDIRAHMAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-397-7135",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judy Kwon
• Hang Nguyet La, RPH
• Ricardo Lafleur, M.D.
• Gretchen Ruth Lafollette, RC
• Margaret R Laird
• Lakeland Family Chiropractic Inc
• Lakeland Sports & Spine Physical Therapy
• Frances Irene Laker, LMP
• Ai Ngau Lam
• Oanh Thi Lam, PMHNP

• Psychiatric/Mental Health Nurse Practitioner in Auburn, WA
• Providers in Auburn, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.