Individual provider Active NPI

Elaine Esther Detwiler, RN

  • Rehabilitation Registered Nurse
  • Seattle, WA
National Provider Identifier
1083794762
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Registered NurseTaxonomy code 163WR0400X
License
13-32998-042 Issued in KS
Practice address
1660 S Columbian Way
#128
Seattle, WA 98108-1532
Phone
(206) 277-3312
Fax
(206) 764-2799
NPI assigned
Oct 16, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Registered Nurse 163WR0400X 13-32998-042 KS Primary

Addresses

Primary practice location

1660 S Columbian Way
#128
Seattle, WA 98108-1532

Mailing address

6649 SE Cougar Mountain Way
Bellevue, WA 98006-5608
Phone (206) 277-3312

Other identifiers 1

IdentifierTypeStateIssuer
13-32998-042OtherKSREGISTERED NURSE

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
13-32998-042KSMDRehabilitation Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083794762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6649 SE COUGAR MOUNTAIN WAY",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980065608",
            "telephone_number": "206-277-3312",
            "fax_number": "206-764-2799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1660 S COLUMBIAN WAY",
            "address_2": "#128",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981081532",
            "telephone_number": "206-277-3312",
            "fax_number": "206-764-2799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETWILER",
        "first_name": "ELAINE",
        "middle_name": "ESTHER",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Rehabilitation",
            "state": "KS",
            "license": "13-32998-042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE",
            "identifier": "13-32998-042",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.