NPIMap

Individual provider Active NPI

Kristin Mellein

  • Family Nurse Practitioner
  • Tulalip, WA
National Provider Identifier
1184024747
Registry record updated Feb 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
60506140 Issued in WA
Practice address
7520 Totem Beach Rd
Tulalip, WA 98271-6160
Phone
(360) 716-4511
NPI assigned
Sep 1, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2015

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 60369533 WA
Family Nurse Practitioner 363LF0000X 60506140 WA Primary

Addresses

Primary practice location

7520 Totem Beach Rd
Tulalip, WA 98271-6160

Mailing address

7520 Totem Beach Rd
Tulalip, WA 98271-6160
Phone (360) 716-4511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170504001372 WA Practitioner - Nurse Practitioner 3779875901 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

11511 Canterwood Blvd NW
Suite 140
Gig Harbor, WA 98332-5817
Phone (253) 530-2940

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60369533WAMDRegistered Nurse
60506140WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Overlake Medical Clinics LLC CurrentSince Jun 12, 2017 Accepting new patients
Emily Program PC CurrentSince Jul 16, 2019 Accepting new patients
Overlake Medical Clinics, LLC CurrentSince Jun 12, 2017 Accepting new patients
Northwest Medical Specialties PLLC CurrentSince May 1, 2021 Accepting new patients
Franciscan Medical Group CurrentSince Sep 16, 2024 Accepting new patients
NFB PLLC CurrentSince Sep 1, 2017 Accepting new patients
Franciscan Medical Group CurrentSince Sep 16, 2024 Accepting new patients
Emily Program P C CurrentSince Jul 16, 2019 Accepting new patients
Franciscan Medical Group Current Accepting new patients
Franciscan Medical Group Past Accepting new patients
Franciscan Medical Group Past Accepting new patients

Locations

2265 Como Ave
Saint Paul, MN 55108

400 108th Ave NE
Ste 100
Bellevue, WA 98004
Phone (425) 467-3785

1750 112th Ave NE
Ste B102
Bellevue, WA 98004
Phone (425) 688-5460

11511 Canterwood Blvd
Ste 140
Gig Harbor, WA 98332
Phone (253) 530-2940

673 Woodland Square Loop SE
Ste 330
Olympia, WA 98503
Phone (415) 710-6689

6800 E Green Lake Way N
Ste 200
Seattle, WA 98115
Phone (206) 524-5656

1700 Westlake Ave N
Ste 700
Seattle, WA 98109
Phone (206) 283-2220

2020 E 29th Ave
Ste 200
Spokane, WA 99203
Phone (509) 252-1366

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

1624 S I St
Ste 305
Tacoma, WA 98405

Organizations & group practices 11

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 5

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": "1409529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424822400000",
    "number": "1184024747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7520 TOTEM BEACH RD",
            "city": "TULALIP",
            "state": "WA",
            "postal_code": "982716160",
            "telephone_number": "360-716-4511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7520 TOTEM BEACH RD",
            "city": "TULALIP",
            "state": "WA",
            "postal_code": "982716160",
            "telephone_number": "360-716-4511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLEIN",
        "first_name": "KRISTIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-01",
        "last_updated": "2015-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "60369533",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "60506140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulalip, WA

Sources for this page

Verify at the official NPI Registry.