Individual provider Active NPI

Gretchen Archer, ARNP

  • Nurse Practitioner
  • Ellensburg, WA
National Provider Identifier
1184690844
Registry record updated Apr 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP30004042 Issued in WA
Practice address
700 E Manitoba Ave Ste 101
Ellensburg, WA 98926-3885
Phone
(509) 925-6100
NPI assigned
Feb 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP30004042 WA Primary

Addresses

Primary practice location

700 E Manitoba Ave Ste 101
Ellensburg, WA 98926-3885

Mailing address

700 E Manitoba Ave Ste 101
Ellensburg, WA 98926-3885
Phone (509) 925-6100

Other practice location 1

500 Lilly Rd NE Ste 200
Olympia, WA 98506-5197
Phone (360) 413-8525

Other identifiers 1

IdentifierTypeStateIssuer
9618398MedicaidWA

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
I20040510000034 WA Practitioner - Nurse Practitioner 4789673344 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

500 Lilly Rd NE
Suite 100
Olympia, WA 98506-5195
Phone (360) 413-8525

525 Lilly Rd NE
Olympia, WA 98506-5101

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP30004042WAMDNurse Practitioner

Interoperability endpoints

  • Direct secure messaging: garcher520250@wm.providencedirect.org

Organizations & group practices 1

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 2

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": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617580800000",
    "number": "1184690844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 E MANITOBA AVE STE 101",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989263885",
            "telephone_number": "509-925-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E MANITOBA AVE STE 101",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989263885",
            "telephone_number": "509-925-6100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Lilly Rd NE Ste 200",
            "address_purpose": "LOCATION",
            "city": "Olympia",
            "state": "WA",
            "postal_code": "985065197",
            "country_code": "US",
            "telephone_number": "360-413-8525",
            "fax_number": "360-412-6477",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ARCHER",
        "first_name": "GRETCHEN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-23",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP30004042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9618398",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellensburg, WA

Sources for this page

Verify at the official NPI Registry.