Active NPI
Advanced Wellness Mental Health, PLLC
- Psychiatry Physician
- Maple Valley, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- Legal business name
- ADVANCED WELLNESS MENTAL HEALTH, PLLC
- Practice address
- 26828 Maple Valley Highway
#202
Maple Valley, WA 98038-1262 - Phone
- (206) 414-9060
- Fax
- (888) 977-3120
- NPI assigned
- May 16, 2019
- Last updated
- Jun 8, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Chandra Kristi Cogburn, ARNP
- Title
- Ceo
- Phone
- (206) 414-9060
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | NU | Primary |
Addresses
Primary practice location
26828 Maple Valley Highway
#202
Maple Valley, WA 98038-1262
Mailing address
26828 Maple Valley Highway
#202
Maple Valley, WA 98038-1262
Phone (206) 414-9060
Other practice location 1
9125 Bridgeport Way SW Ste 102
Lakewood, WA 98499-2448
Phone (206) 414-9060
National Provider Directory
National Provider DirectoryLocations
26828 Black Diamond Rd SE
Maple Valley, WA 98038
Phone (206) 446-0122
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Psychiatric/Mental Health Nurse Practitioner
- Puyallup, WA
- NPI 1235589128
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557964800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1559952000000",
"number": "1154987931",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26828 MAPLE VALLEY HIGHWAY",
"address_2": "#202",
"city": "MAPLE VALLEY",
"state": "WA",
"postal_code": "980381262",
"telephone_number": "206-414-9060",
"fax_number": "888-977-3120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26828 MAPLE VALLEY HIGHWAY",
"address_2": "#202",
"city": "MAPLE VALLEY",
"state": "WA",
"postal_code": "980381262",
"telephone_number": "206-414-9060",
"fax_number": "888-977-3120"
}
],
"practiceLocations": [
{
"address_1": "9125 Bridgeport Way SW Ste 102",
"address_purpose": "LOCATION",
"city": "Lakewood",
"state": "WA",
"postal_code": "984992448",
"country_code": "US",
"telephone_number": "206-414-9060",
"fax_number": "888-977-3120",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "ADVANCED WELLNESS MENTAL HEALTH, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-05-16",
"last_updated": "2019-06-08",
"status": "A",
"authorized_official_last_name": "COGBURN",
"authorized_official_first_name": "CHANDRA",
"authorized_official_middle_name": "KRISTI",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "206-414-9060",
"authorized_official_credential": "ARNP"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maple Valley, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.