Individual provider Active NPI

Kristine Pennella McMurray, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Everett, WA
National Provider Identifier
1073820288
Registry record updated Apr 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP60169850 Issued in WA
Practice address
811 Madison St
Everett, WA 98203-4543
Phone
(425) 212-4200
Fax
(425) 212-4220
NPI assigned
Sep 9, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP60169850 WA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP60169850 WA Primary

Addresses

Primary practice location

811 Madison St
Everett, WA 98203-4543

Mailing address

PO Box 2569
Everett, WA 98213-0569
Phone (425) 212-4200

Other practice location 1

8927 W Tucannon Ave Ste 102
Kennewick, WA 99336-7176
Phone (509) 572-9330

Other identifiers 1

IdentifierTypeStateIssuer
2009335MedicaidWA

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP60169850WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sunrise Services, Inc. CurrentSince May 9, 2022 Accepting new patients
Tri Cities Community Health Past Accepting new patients
Raymond H Sjerven DO Past Accepting new patients
Desert Sage Psychiatry Psychiatric/Mental Health PastSince Mar 6, 2022 Accepting new patients

Locations

2500 E College Way
Mount Vernon, WA 98273
Phone (360) 336-3762

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": "1283990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650499200000",
    "number": "1073820288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2569",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982130569",
            "telephone_number": "425-212-4200",
            "fax_number": "425-212-4220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 MADISON ST",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982034543",
            "telephone_number": "425-212-4200",
            "fax_number": "425-212-4220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8927 W Tucannon Ave Ste 102",
            "address_purpose": "LOCATION",
            "city": "Kennewick",
            "state": "WA",
            "postal_code": "993367176",
            "country_code": "US",
            "telephone_number": "509-572-9330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCMURRAY",
        "first_name": "KRISTINE",
        "middle_name": "PENNELLA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-09",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60169850",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP60169850",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2009335",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 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.