Individual provider Active NPI

Shannon Michal Latta, ARNP

  • Family Nurse Practitioner
  • Federal Way, WA
National Provider Identifier
1194956672
Registry record updated Aug 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP60098107 Issued in WA
Practice address
3201 S 323Rd St
Federal Way, WA 98001-5023
Phone
(360) 810-8895
Fax
(877) 780-0122
NPI assigned
Aug 2, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP60098107 WA Primary
Family Nurse Practitioner 363LF0000X RN00147326 WA

Addresses

Primary practice location

3201 S 323Rd St
Federal Way, WA 98001-5023

Mailing address

3201 S 323Rd St
Federal Way, WA 98001-5023
Phone (360) 810-8895

Other identifiers 3

IdentifierTypeStateIssuer
9662628MedicaidWA
0254476OtherWALABOR & INDUSTRIES
2003611MedicaidWA

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
I20091022000747 WA Practitioner - Nurse Practitioner 9436296498 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Washington School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Optum Care Washington PLLCGroup PAC ID 6406752153, 684 clinicians

Practice addresses (Care Compare)

4420 76TH St NE
Marysville, WA 98270-3726
Phone (360) 651-7490

Hospital & facility affiliations

  • Providence Regional Medical Center Everett Hospital, Everett, WA, CCN 500014

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN00147326WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Care Washington PLLC CurrentSince May 21, 2012 Accepting new patients
Optum Care Washington PLLC CurrentSince May 21, 2012 Accepting new patients
Optum Care Washington PLLC Past Accepting new patients

Locations

1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903

4420 76th St NE
Marysville, WA 98270
Phone (360) 651-7490

1201 N 175th St
Shoreline, WA 98133
Phone (425) 339-4299

Interoperability endpoints

  • Direct secure messaging: slatta12542@direct.tecmc.com

Organizations & group practices 3

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": "1249171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787011200000",
    "number": "1194956672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 S 323RD ST",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980015023",
            "telephone_number": "360-810-8895",
            "fax_number": "877-780-0122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 S 323RD ST",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980015023",
            "telephone_number": "360-810-8895",
            "fax_number": "877-780-0122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATTA",
        "first_name": "SHANNON",
        "middle_name": "MICHAL",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-02",
        "last_updated": "2026-08-18",
        "certification_date": "2026-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60098107",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "RN00147326",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9662628",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "0254476",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2003611",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Federal Way, WA

Sources for this page

Verify at the official NPI Registry.