Individual provider Active NPI

Amanda Michelle Gutierrez, MSN, ARNP, FNP-C

  • Family Nurse Practitioner
  • Yakima, WA
National Provider Identifier
1134801301
Registry record updated Sep 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP61484325 Issued in WA
Practice address
2811 Tieton Dr
Yakima, WA 98902-3761
Phone
(509) 575-8100
NPI assigned
Aug 7, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP61484325 WA Primary
Emergency Registered Nurse 163WE0003X RN60562253 WA

Addresses

Primary practice location

2811 Tieton Dr
Yakima, WA 98902-3761

Mailing address

706 Terry LN
Selah, WA 98942-8862
Phone (509) 949-2530

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
I20231024000447 WA Practitioner - Nurse Practitioner 5294181533 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yakima Valley Memorial PhysiciansGroup PAC ID 1557391596, 397 clinicians

Practice addresses (Care Compare)

2811 Tieton Dr
Yakima, WA 98902-3761
Phone (509) 575-8000

Hospital & facility affiliations

  • Yakima Valley Memorial Hospital, Yakima, WA, CCN 500036

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

Practice roles

OrganizationSpecialtyStatusNew patients
Yakima Valley Memorial Physicians CurrentSince Nov 1, 2023 Accepting new patients
Yakima Valley Memorial Physicians CurrentSince Nov 1, 2023 Accepting new patients
Yakima Valley Memorial Physicians Current Accepting new patients

Locations

2811 Tieton Dr
Yakima, WA 98902
Phone (509) 249-5210

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1691366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695427200000",
    "number": "1134801301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 TERRY LN",
            "city": "SELAH",
            "state": "WA",
            "postal_code": "989428862",
            "telephone_number": "509-949-2530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2811 TIETON DR",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023761",
            "telephone_number": "509-575-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "AMANDA",
        "middle_name": "MICHELLE",
        "credential": "MSN, ARNP, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-07",
        "last_updated": "2023-09-23",
        "certification_date": "2023-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61484325",
            "primary": true
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "WA",
            "license": "RN60562253",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.