Individual provider Active NPI

Brenda Martinez Davila, RN

  • Family Nurse Practitioner
  • Lynnwood, WA
National Provider Identifier
1124846266
Registry record updated Sep 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP61653139 Issued in WA
Practice address
4111 Alderwood Mall Blvd
Lynnwood, WA 98036-6765
Phone
(425) 616-4100
Fax
(425) 616-4115
NPI assigned
Sep 27, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN61249432 WA
Family Nurse Practitioner 363LF0000X AP61653139 WA Primary

Addresses

Primary practice location

4111 Alderwood Mall Blvd
Lynnwood, WA 98036-6765

Mailing address

PO Box 34703
Seattle, WA 98124-1703

Other practice location 1

232 2nd Ave S
Kent, WA 98032-5862
Phone (206) 436-6380

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250501002342 WA Practitioner - Nurse Practitioner 4587180682 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Sea-Mar Community Health Center CurrentSince Feb 20, 2025 Accepting new patients
Sea Mar Community Health Centers Registered Nurse CurrentSince Feb 20, 2025 Accepting new patients
Sea Mar Community Health Centers Family Current Accepting new patients

Locations

4111 Alderwood Mall Blvd
Lynnwood, WA 98036
Phone (425) 616-4100

1400 N Laventure Rd
Mount Vernon, WA 98273
Phone (360) 428-4075

1040 S Henderson St
Seattle, WA 98108
Phone (206) 763-5210

Interoperability endpoints

  • Direct secure messaging: bdavila731913@direct.multicare.org

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": "1727395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757462400000",
    "number": "1124846266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34703",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4111 ALDERWOOD MALL BLVD",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980366765",
            "telephone_number": "425-616-4100",
            "fax_number": "425-616-4115"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "232 2nd Ave S",
            "address_purpose": "LOCATION",
            "city": "Kent",
            "state": "WA",
            "postal_code": "980325862",
            "country_code": "US",
            "telephone_number": "206-436-6380",
            "fax_number": "206-436-6368",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVILA",
        "first_name": "BRENDA",
        "middle_name": "MARTINEZ",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-27",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN61249432",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61653139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

Verify at the official NPI Registry.