Individual provider Active NPI

Rahel Hailegeorgies Bushen, RN

  • Registered Nurse
  • Puyallup, WA
National Provider Identifier
1063137966
Registry record updated Oct 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN61065363 Issued in WA
Practice address
10705 185TH St E
Puyallup, WA 98374-6518
Phone
(206) 307-9669
NPI assigned
Oct 4, 2022
Last updated
Oct 4, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN61065363 WA Primary

Addresses

Primary practice location

10705 185TH St E
Puyallup, WA 98374-6518

Mailing address

10705 185TH St E
Puyallup, WA 98374-6518
Phone (206) 307-9669

Other identifiers 1

IdentifierTypeStateIssuer
NONEOtherNONE

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
RN61065363WAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1664841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1063137966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10705 185TH ST E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983746518",
            "telephone_number": "206-307-9669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10705 185TH ST E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983746518",
            "telephone_number": "206-307-9669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSHEN",
        "first_name": "RAHEL",
        "middle_name": "HAILEGEORGIES",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-04",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN61065363",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "NONE",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2022; 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.