Samara Alexis Glavin, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP61403677 Issued in WA

Practice address

5512 NE 109TH CT Ste I
Vancouver, WA 98662-6175

Phone

(360) 200-5273

NPI assigned

Nov 21, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Samara Alexis Glavin Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Med RX Partners, P.C.

  • Psychiatric/Mental Health Nurse Practitioner
  • Vancouver, WA
  • NPI 1114586070
  NPD (past)
• Med RX Partners, PC

  • Psychiatric/Mental Health Nurse Practitioner
  • Portland, OR
  • NPI 1528881299
  NPD (past)

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

{
    "created_epoch": "1668988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676937600000",
    "number": "1053020867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5512 NE 109TH CT STE I",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626175",
            "telephone_number": "360-200-5273",
            "fax_number": "833-593-8274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5512 NE 109TH CT STE I",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626175",
            "telephone_number": "360-200-5273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLAVIN",
        "first_name": "SAMARA",
        "middle_name": "ALEXIS",
        "name_prefix": "Mrs.",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-21",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61403677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMARA",
            "last_name": "GLAVIN",
            "middle_name": "ALEXIS",
            "prefix": "MRS.",
            "credential": "PMHNP-BC, MSN, RN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Michael J Glanzer, OD
• Evening Rose Glaser, PA-C
• Graham D Glass, MD
• Krista Lorraine Glasson Killmer, PHARM.D.
• Haley Glassy
• Andee Gleason
• Barbara Gleason
• Sherry D Gleave, LMP
• Michelle Glenn
• Raemaris Glenn, DC

• Psychiatric/Mental Health Nurse Practitioner in Vancouver, WA
• Providers in Vancouver, 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 Feb 21, 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.