Individual provider Active NPI

Marilyn Criddle, A.R.N.P., PH.D

  • Adult Psychiatric/Mental Health Clinical Nurse Specialist
  • Seattle, WA
National Provider Identifier
1114013612
Registry record updated Apr 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X
License
AP30000645 Issued in WA
Practice address
411 University St
Suite 1200
Seattle, WA 98101-2507
Phone
(206) 624-1552
Fax
(206) 467-0212
NPI assigned
Oct 4, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP30000645 WA
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X AP30000645 WA Primary

Addresses

Primary practice location

411 University St
Suite 1200
Seattle, WA 98101-2507

Mailing address

411 University St
Suite 1200
Seattle, WA 98101-2507
Phone (206) 624-1552

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, Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554854400000",
    "number": "1114013612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 UNIVERSITY ST",
            "address_2": "SUITE 1200",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981012507",
            "telephone_number": "206-624-1552",
            "fax_number": "206-467-0212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 UNIVERSITY ST",
            "address_2": "SUITE 1200",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981012507",
            "telephone_number": "206-624-1552",
            "fax_number": "206-467-0212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRIDDLE",
        "first_name": "MARILYN",
        "name_prefix": "Dr.",
        "credential": "A.R.N.P., PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2019-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP30000645",
            "primary": false
        },
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "WA",
            "license": "AP30000645",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Apr 10, 2019; 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.