Garrett Clay Wistisen, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP61662619 Issued in WA

Practice address

1550 S Pioneer Way Ste 100
Moses Lake, WA 98837-4637

Phone

(509) 793-9770

NPI assigned

Feb 19, 2025

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Grant County Public Hospital District 1Group PAC ID 9931095692, 112 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Samaritan Hospital Hospital, Moses Lake, WA, CCN 500033

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gwistisen2029453@wm.providencedirect.org

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.

• Grant County Public Hospital District 1

  • Rural Health Clinic/Center
  • Moses Lake, WA
  • NPI 1619086766
  Medicare reassignment Care Compare group NPD
• Grant County Public Hospital District 1

  • Rural Health Clinic/Center
  • Moses Lake, WA
  • NPI 1609112739
  NPD
• Grant County Public Hospital District 1

  • General Acute Care Hospital
  • Moses Lake, WA
  • NPI 1902818883
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Grant County Public Hospital District 1

  • General Acute Care Hospital
  • Moses Lake, WA
  • NPI 1902818883
  Care Compare affiliation

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

{
    "created_epoch": "1739923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777852800000",
    "number": "1124824370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 S PIONEER WAY",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988372487",
            "telephone_number": "509-793-9715",
            "fax_number": "509-764-3244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 S PIONEER WAY STE 100",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988374637",
            "telephone_number": "509-793-9770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISTISEN",
        "first_name": "GARRETT",
        "middle_name": "CLAY",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-02-19",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61662619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2319106",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gwistisen2029453@wm.providencedirect.org",
            "affiliation": "N",
            "endpointDescription": "EMR EPIC",
            "address_1": "1550 S Pioneer Way Ste 100",
            "city": "Moses Lake",
            "state": "WA",
            "country_code": "US",
            "postal_code": "988374637",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ciara Wilson, LMP
• Luz Menendez Wilson, RN
• Rebeca Wilson
• Rebecca L.S. Winn, NLMP
• Gus Winter, MED
• Mackenzie Lee Wittenbarger
• Dana A Wolf, MS
• India Nicole Wolfendale, PA-C
• Casey Verl Woolsey, MSHS, PA-C
• Jared Rex Wortham, DO

• Family Nurse Practitioner in Moses Lake, WA
• Providers in Moses Lake, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.