NPIMap

Organization Active NPI

Spectrum Care, PLLC

Doing business as Kimmer Collison-Ris FNP-BC, MS CAM

  • Family Nurse Practitioner
  • Lynnwood, WA
National Provider Identifier
1053798546
Registry record updated May 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP30006553 Issued in WA
Legal business name
SPECTRUM CARE, PLLC
Doing business as
Kimmer Collison-Ris FNP-BC, MS CAM
Practice address
16825 48TH Ave W
117
Lynnwood, WA 98037-6401
Phone
(425) 210-4187
Fax
(425) 361-1704
NPI assigned
May 4, 2015
Last updated
May 4, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2015

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

Authorized official

Name
Ms. Kimberly 'Kimmer' Verlynn Collison-Ris, MSN FNP-BC WOCN CAMNPI 1124149026
Title
Owner/Provider
Phone
42521041187

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X AP30006553 WA Primary

Addresses

Primary practice location

16825 48TH Ave W
117
Lynnwood, WA 98037-6401

Mailing address

5908 149TH PL SW
Edmonds, WA 98026
Phone (425) 210-4187

Other names 1

  • Kimmer Collison-Ris FNP-BC, MS CAM Doing business as

National Provider Directory

National Provider Directory

Locations

16825 48th Ave W
Ste 117
Lynnwood, WA 98037
Phone (425) 210-4187

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1430697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430697600000",
    "number": "1053798546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5908 149TH PL SW",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "98026",
            "telephone_number": "425-210-4187",
            "fax_number": "425-361-1704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16825 48TH AVE W",
            "address_2": "117",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980376401",
            "telephone_number": "425-210-4187",
            "fax_number": "425-361-1704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-04",
        "last_updated": "2015-05-04",
        "status": "A",
        "authorized_official_last_name": "COLLISON-RIS",
        "authorized_official_first_name": "KIMBERLY 'KIMMER'",
        "authorized_official_middle_name": "VERLYNN",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "42521041187",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MSN FNP-BC WOCN CAM"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP30006553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kimmer Collison-Ris FNP-BC, MS CAM",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lynnwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2015; 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.