NPIMap

Organization Active NPI

Rainier Valley Wellness

  • Nurse Practitioner
  • Seattle, WA
National Provider Identifier
1114636669
Registry record updated Dec 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
RAINIER VALLEY WELLNESS
Practice address
4708 S Mead St
Seattle, WA 98118-2810
Phone
(206) 474-6267
NPI assigned
Nov 22, 2022
Organization subpart
Yes
Parent organization
RAINIER VALLEY COMMUNITY CLINICAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 9, 2022

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

Authorized official

Name
Tara Kaleilani Lawal, MS RNNPI 1487196986
Title
Executive Director
Phone
(206) 474-6267

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

4708 S Mead St
Seattle, WA 98118-2810

Mailing address

4704 S Mead St
Seattle, WA 98118-2810
Phone (206) 474-6267

Other names 1

  • South Seattle Women's Health Foundation Former legal business name

National Provider Directory

National Provider Directory
Part of
Rainier Valley Community Clinic

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1669075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670544000000",
    "number": "1114636669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4704 S MEAD ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981182810",
            "telephone_number": "206-474-6267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4708 S MEAD ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981182810",
            "telephone_number": "206-474-6267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAINIER VALLEY WELLNESS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RAINIER VALLEY COMMUNITY CLINIC",
        "enumeration_date": "2022-11-22",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-07",
        "status": "A",
        "authorized_official_last_name": "LAWAL",
        "authorized_official_first_name": "TARA",
        "authorized_official_middle_name": "KALEILANI",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "206-474-6267",
        "authorized_official_credential": "MS RN"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Seattle Women's Health Foundation",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "South Seattle Women's Health Foundation",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Dec 9, 2022; 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.