Active NPI
Marilyn Criddle, A.R.N.P., PH.D
- Adult Psychiatric/Mental Health Clinical Nurse Specialist
- Seattle, WA
National Provider Identifier
1114013612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Psychiatric/Mental Health Clinical Nurse Specialist
- License
- AP30000645
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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.