Individual provider Active NPI

Prisca Nwizugbo, ARNP, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Renton, WA
National Provider Identifier
1184922874
Registry record updated May 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP60196567 Issued in WA
Practice address
15 S Grady Way Ste 249
Renton, WA 98057-3209
Phone
(425) 233-0431
Fax
(425) 329-8087
NPI assigned
Mar 4, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP60196567 WA Primary

Addresses

Primary practice location

15 S Grady Way Ste 249
Renton, WA 98057-3209

Mailing address

15 S Grady Way Ste 249
Renton, WA 98057-3209
Phone (425) 233-0431

Other practice location 1

15 S Grady Way Ste 625
Renton, WA 98057-3281
Phone (425) 919-6826

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address office@opmhs.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240321000469 WA Order and Referring Only - Nurse PractitionerPractitioner - Psychiatry 1052599172

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Optimum Mental Health Services, LLC Psychiatric/Mental Health CurrentSince Sep 1, 2022 Accepting new patients
Eastside TMS X Wellness Center Psychiatric/Mental Health PastSince Sep 1, 2022 Accepting new patients

Locations

15 S Grady Way
Ste 625
Renton, WA 98057
Phone (425) 233-0431

15 S Grady Way
Ste 249
Renton, WA 98057
Phone (253) 220-9452

Organizations & group practices 2

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": "1299196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779753600000",
    "number": "1184922874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 S GRADY WAY STE 249",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980573209",
            "telephone_number": "425-233-0431",
            "fax_number": "425-329-8087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 S GRADY WAY STE 249",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980573209",
            "telephone_number": "425-233-0431",
            "fax_number": "425-329-8087"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 S Grady Way Ste 625",
            "address_purpose": "LOCATION",
            "city": "Renton",
            "state": "WA",
            "postal_code": "980573281",
            "country_code": "US",
            "telephone_number": "425-919-6826",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NWIZUGBO",
        "first_name": "PRISCA",
        "name_prefix": "Miss",
        "credential": "ARNP, PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-04",
        "last_updated": "2026-05-26",
        "certification_date": "2026-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP60196567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "office@opmhs.com",
            "affiliation": "N",
            "endpointDescription": "Secure email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "15 S Grady Way Ste 249",
            "city": "Renton",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980573209",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

Verify at the official NPI Registry.