Individual provider Active NPI

Michelle D'Anne Kassens, CNM, ARNP

  • Advanced Practice Midwife
  • Vancouver, WA
National Provider Identifier
1104100569
Registry record updated Dec 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
AP 60237682 Issued in WA
Practice address
700 NE 87TH Ave
Vancouver, WA 98664-4896
Phone
(360) 882-2778
Fax
(360) 604-1653
NPI assigned
Oct 4, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X AP 60237682 WA Primary

Addresses

Primary practice location

700 NE 87TH Ave
Vancouver, WA 98664-4896

Mailing address

1329 Ham Hill Rd
Centralia, WA 98531-5231
Phone (360) 623-0458

Other identifiers 1

IdentifierTypeStateIssuer
2014928MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
AP 60237682WAMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
The Vancouver Clinic Inc PS CurrentSince Jan 13, 2020 Accepting new patients
Capital Medical Center Specialty Physicians, LLC CurrentSince Nov 15, 2022 Accepting new patients
The Vancouver Clinic Inc PS CurrentSince Jan 13, 2020 Accepting new patients

Locations

3920 Capital Mall Dr SW
Ste 402
Olympia, WA 98502
Phone (360) 704-4786

3900 Capital Mall Dr SW
Olympia, WA 98502
Phone (360) 704-4743

700 NE 87th Ave
Vancouver, WA 98664
Phone (360) 397-1500

2525 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1500

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1317686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575936000000",
    "number": "1104100569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1329 HAM HILL RD",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985315231",
            "telephone_number": "360-623-0458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 NE 87TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986644896",
            "telephone_number": "360-882-2778",
            "fax_number": "360-604-1653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASSENS",
        "first_name": "MICHELLE",
        "middle_name": "D'ANNE",
        "credential": "CNM, ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-04",
        "last_updated": "2019-12-10",
        "certification_date": "2019-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "WA",
            "license": "AP 60237682",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2014928",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.