Individual provider Active NPI

Shayne Summers Yocum, ARNP

  • Nurse Practitioner
  • Seattle, WA
National Provider Identifier
1043511181
Registry record updated Jul 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP60265340 Issued in WA
Practice address
325 9TH Ave
Seattle, WA 98104-2499
Phone
(206) 744-3347
Fax
(206) 744-9331
NPI assigned
Nov 5, 2010
Last updated
Jul 19, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP60265340 WA Primary

Addresses

Primary practice location

325 9TH Ave
Seattle, WA 98104-2499

Mailing address

325 9TH Ave
Seattle, WA 98104-2499
Phone (206) 744-3347

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
I20120820000941 WA Practitioner - Nurse Practitioner 1456508878 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP60265340WAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nordquist Integrated Medicine Nurse Practitioner CurrentSince Sep 18, 2023 Accepting new patients
Bremerton Wellness PS CurrentSince Jan 22, 2019 Accepting new patients
Iroc PS CurrentSince Aug 28, 2023 Accepting new patients
Kingston Crossing Wellness PS CurrentSince Jan 22, 2019 Accepting new patients
Fox Chiropractic Wellness Center PS CurrentSince Jul 30, 2021 Accepting new patients
E & H Holdings, LLC Past Accepting new patients

Locations

5050 State Highway 303 NE
Ste 101A
Bremerton, WA 98311
Phone (360) 478-6978

3715 56th St
Gig Harbor, WA 98335
Phone (253) 851-5138

8202 NE State Highway 104
Ste 105
Kingston, WA 98346
Phone (360) 297-0037

9909 168th St E
Ste 102
Puyallup, WA 98375
Phone (253) 445-3000

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1288915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342656000000",
    "number": "1043511181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 9TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981042499",
            "telephone_number": "206-744-3347",
            "fax_number": "206-744-9331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 9TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981042499",
            "telephone_number": "206-744-3347",
            "fax_number": "206-744-9331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOCUM",
        "first_name": "SHAYNE",
        "middle_name": "SUMMERS",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-05",
        "last_updated": "2012-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP60265340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.