Individual provider Active NPI

Brenda L Powell, MD

  • Family Medicine Physician
  • Port Angeles, WA
National Provider Identifier
1194800565
Registry record updated Nov 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD60341332 Issued in WA
Practice address
243511 Highway 101
Port Angeles, WA 98363-9472
Phone
(360) 452-6252
NPI assigned
Oct 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD60341332 WA Primary

Addresses

Primary practice location

243511 Highway 101
Port Angeles, WA 98363-9472

Mailing address

243511 Highway 101
Port Angeles, WA 98363-9472
Phone (360) 452-6252

Other identifiers 1

IdentifierTypeStateIssuer
2027695MedicaidWA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130723000498 WA Practitioner - Family Practice 9436193810 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Duke University School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lower Elwha Klallam TribeGroup PAC ID 0446240964, shared by 2 NPIs, 4 clinicians

Practice addresses (Care Compare)

243511 Hwy 101
Port Angeles, WA 98363-9472
Phone (360) 452-6252

Hospital & facility affiliations

  • Olympic Medical Center Hospital, Port Angeles, WA, CCN 500072

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD60341332WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Seattle Indian Health Board Family Medicine CurrentSince Jan 1, 2026 Accepting new patients
Seattle Indian Health Board CurrentSince Jan 1, 2026 Accepting new patients
Seattle Indian Health Board Past Accepting new patients

Locations

124 2nd Ave S
Seattle, WA 98104
Phone (206) 292-6214

12736 33rd Ave NE
#200
Seattle, WA 98125
Phone (206) 324-9360

611 12th Ave S
Seattle, WA 98144
Phone (206) 324-9360

Interoperability endpoints

  • Direct secure messaging: brenda.powell@direct.lower-elwha-klallam.nextgenshare.com

Organizations & group practices 4

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": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1194800565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243511 HIGHWAY 101",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983639472",
            "telephone_number": "360-452-6252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243511 HIGHWAY 101",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983639472",
            "telephone_number": "360-452-6252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "BRENDA",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60341332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2027695",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Angeles, WA

Sources for this page

Verify at the official NPI Registry.