Individual provider Active NPI

Ola Chinma Anyanwu, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Seattle, WA
National Provider Identifier
1083360945
Registry record updated Jun 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP61676559 Issued in WA
Practice address
101 Elliott Ave W Ste 500
Seattle, WA 98119-4292
Phone
(214) 403-6744
NPI assigned
Mar 1, 2022
Last updated
Jun 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X 1071804 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X C-RXN-0002051-C-NP CO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 49705 WY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP61676559 WA Primary

Addresses

Primary practice location

101 Elliott Ave W Ste 500
Seattle, WA 98119-4292

Mailing address

100 N Howard St Ste R
Spokane, WA 99201-0508
Phone (307) 630-4729

Other practice location 1

Liv Health
2622 Pioneer Avenue
Cheyenne, WY 82001
Phone (307) 630-4729

Other practice location 2

322 Andre Dr
Irving, TX 75063-5346
Phone (214) 403-6744

Other practice location 3

402 W Wheatland Rd Ste 140
Duncanville, TX 75116-4628
Phone (972) 503-4109

Other practice location 4

1301 Riverside Ave
Fort Collins, CO 80524-4374
Phone (970) 888-4070

Other practice location 5

2500 Dell Range Blvd
Cheyenne, WY 82009-5273
Phone (307) 630-4729

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY, CO, WA3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20220512001177 WY Practitioner - Nurse Practitioner 0042697021 Reassigns benefits to 1 organization
I20220525000353 CO Practitioner - Nurse Practitioner 0042697021 Reassigns benefits to 1 organization
I20250617001449 WA Practitioner - Nurse Practitioner 0042697021 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mindful Therapy Group PCGroup PAC ID 4981872561, 654 clinicians

Practice addresses (Care Compare)

101 Elliott Ave W
Suite 500
Seattle, WA 98119-4292
Phone (425) 640-7009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
C-RXN-0002051-C-NPCOMDPsychiatric/Mental Health Nurse Practitioner
1071804TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mindful Therapy Group PC Single Specialty CurrentSince Jun 4, 2025 Accepting new patients
Pec Medical Consulting, PLLC Single Specialty CurrentSince Nov 13, 2022 Accepting new patients
Cardinal Support LLC Single Specialty CurrentSince Mar 1, 2022 Accepting new patients

Locations

402 W Wheatland Rd
Ste 140
Duncanville, TX 75116
Phone (833) 691-3273

21907 64th Ave W
Ste 200
Mountlake Terrace, WA 98043
Phone (410) 258-3698

6505 216th St SW
Ste 100
Mountlake Terrace, WA 98043
Phone (425) 678-6463

101 Elliott Ave W
Ste 500
Seattle, WA 98119
Phone (206) 708-6432

320 NE 97th St
Ste A
Seattle, WA 98115
Phone (206) 323-8113

201 W North River Dr
Ste 301
Spokane, WA 99201
Phone (509) 378-4824

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": "1646092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749686400000",
    "number": "1083360945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N HOWARD ST STE R",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992010508",
            "telephone_number": "307-630-4729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 ELLIOTT AVE W STE 500",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981194292",
            "telephone_number": "214-403-6744"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "LIV HEALTH",
            "address_2": "2622 PIONEER AVENUE",
            "address_purpose": "LOCATION",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "82001",
            "country_code": "US",
            "telephone_number": "307-630-4729",
            "fax_number": "307-632-3298",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "322 Andre Dr",
            "address_purpose": "LOCATION",
            "city": "Irving",
            "state": "TX",
            "postal_code": "750635346",
            "country_code": "US",
            "telephone_number": "214-403-6744",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "402 W Wheatland Rd Ste 140",
            "address_purpose": "LOCATION",
            "city": "Duncanville",
            "state": "TX",
            "postal_code": "751164628",
            "country_code": "US",
            "telephone_number": "972-503-4109",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1301 Riverside Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Collins",
            "state": "CO",
            "postal_code": "805244374",
            "country_code": "US",
            "telephone_number": "970-888-4070",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2500 Dell Range Blvd",
            "address_purpose": "LOCATION",
            "city": "Cheyenne",
            "state": "WY",
            "postal_code": "820095273",
            "country_code": "US",
            "telephone_number": "307-630-4729",
            "fax_number": "307-632-3298",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANYANWU",
        "first_name": "OLA",
        "middle_name": "CHINMA",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-01",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1071804",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "C-RXN-0002051-C-NP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WY",
            "license": "49705",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61676559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.