Individual provider Active NPI

Mindy Tanimoto, ARNP, FNP-BC

  • Family Nurse Practitioner
  • Kennewick, WA
National Provider Identifier
1043767122
Registry record updated Sep 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP60692107 Issued in WA
Practice address
124 W Kennewick Ave Ste 11
Kennewick, WA 99336-3830
Phone
(541) 303-3558
Fax
(509) 593-4644
NPI assigned
Sep 6, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP60692107 WA Primary

Addresses

Primary practice location

124 W Kennewick Ave Ste 11
Kennewick, WA 99336-3830

Mailing address

560 Gage Blvd
Suite 203
Richland, WA 99352
Phone (509) 942-3627

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
I20170426000569 WA Practitioner - Nurse Practitioner 9739466970 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
89.49 of 100Reported as group
Quality
86.28
Promoting interoperability
100
Improvement activities
40
Cost
78.7

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New Life Wellness LLC Family CurrentSince Jun 15, 2026 Accepting new patients
Providence Health & Services - Washington Past Accepting new patients
Kadlec Regional Medical Center Past Accepting new patients

Locations

124 W Kennewick Ave
Ste 9
Kennewick, WA 99336

124 W Kennewick Ave
Ste 11
Kennewick, WA 99336

Organizations & group practices 4

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": "1473120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790121600000",
    "number": "1043767122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 GAGE BLVD",
            "address_2": "SUITE 203",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "99352",
            "telephone_number": "509-942-3627",
            "fax_number": "509-942-2268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 W KENNEWICK AVE STE 11",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993363830",
            "telephone_number": "541-303-3558",
            "fax_number": "509-593-4644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANIMOTO",
        "first_name": "MINDY",
        "credential": "ARNP, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-06",
        "last_updated": "2026-09-23",
        "certification_date": "2026-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60692107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennewick, WA

Sources for this page

Verify at the official NPI Registry.