Northwest Mobile Medicine LLC

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

AP6013222 Issued in WA

Legal business name

NORTHWEST MOBILE MEDICINE LLC

Practice address

1514 Nob Hill Ave N
Seattle, WA 98109-3141

Phone

(206) 920-5583

NPI assigned

Sep 12, 2011

Organization subpart

No

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

Authorized official

Name

Ms. Lynne Marie Wiegert, ARNP, GNP-BC

Title

Owner

Phone

(206) 920-5583

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1315785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315785600000",
    "number": "1093097438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 NOB HILL AVE N",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981093141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1514 NOB HILL AVE N",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981093141",
            "telephone_number": "206-920-5583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST MOBILE MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-12",
        "last_updated": "2011-09-12",
        "status": "A",
        "authorized_official_last_name": "WIEGERT",
        "authorized_official_first_name": "LYNNE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-920-5583",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "ARNP, GNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WA",
            "license": "AP6013222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gerontology Nurse Practitioner in Seattle, WA
• Providers in Seattle, WA by specialty
• Gerontology Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2011; 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.