Individual provider Active NPI

Michelle Dwyer, R.N.

  • Home Health Registered Nurse
  • Mountlake Terrace, WA
National Provider Identifier
1053743641
Registry record updated Aug 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
License
RN00088801 Issued in WA
Practice address
22702 Lake View Drive Unit G4
Mountlake Terrace, WA 98043-2354
Phone
(206) 992-4003
NPI assigned
Aug 6, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X RN00088801 WA Primary

Addresses

Primary practice location

22702 Lake View Drive Unit G4
Mountlake Terrace, WA 98043-2354

Mailing address

22702 Lake View Drive G4
Mountlake Terrace, WA 98043-2354
Phone (206) 992-4003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN00088801WAMDHome Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1375747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375747200000",
    "number": "1053743641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22702 LAKE VIEW DRIVE G4",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980432354",
            "telephone_number": "206-992-4003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22702 LAKE VIEW DRIVE UNIT G4",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980432354",
            "telephone_number": "206-992-4003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DWYER",
        "first_name": "MICHELLE",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-06",
        "last_updated": "2013-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "WA",
            "license": "RN00088801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountlake Terrace, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2013; 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.