Individual provider Active NPI

Nadine A Smith, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Vancouver, WA
National Provider Identifier
1205082062
Registry record updated Mar 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
60717374 Issued in WA
Practice address
4400 NE 77TH Ave Ste 275
Vancouver, WA 98662-6857
Phone
(360) 567-8466
Fax
(660) 951-7859
NPI assigned
Aug 13, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2026

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 201703459NP-PP OR
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X C-APN.0003490-C-NP CO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 60717374 WA Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NP95001782 CA
Women's Health Nurse Practitioner 363LW0102X R146902 MD
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R146902 MD

Addresses

Primary practice location

4400 NE 77TH Ave Ste 275
Vancouver, WA 98662-6857

Mailing address

4400 NE 77TH Ave Ste 275
Vancouver, WA 98662-6857
Phone (360) 567-8466

Other practice location 1

7100 Guilford Dr # 2071
Frederick, MD 21704-5257
Phone (360) 567-8466

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190222002011 WA Practitioner - Nurse Practitioner 5294976106 Reassigns benefits to 2 organizations
I20191003000669 OR Practitioner - Nurse Practitioner 5294976106 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP95001782CAMDPsychiatric/Mental Health Nurse Practitioner
C-APN.0003490-C-NPCOMDPsychiatric/Mental Health Nurse Practitioner
R146902MDMDPsychiatric/Mental Health Nurse Practitioner
201703459NP-PPORMDPsychiatric/Mental Health Nurse Practitioner
60717374WAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest Single Specialty CurrentSince Jul 8, 2019 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Jul 8, 2019 Accepting new patients
Rainier Springs Physician Group, LLC Single Specialty CurrentSince Dec 10, 2018 Accepting new patients
Magnolia Psychiatric Services PLLC Single Specialty Past Accepting new patients

Locations

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

500 NE Multnomah St
Portland, OR 97232
Phone (503) 813-4939

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

2805 NE 129th St
Vancouver, WA 98686
Phone (360) 356-1890

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1218585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773100800000",
    "number": "1205082062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 NE 77TH AVE STE 275",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626857",
            "telephone_number": "360-567-8466",
            "fax_number": "660-951-7859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 NE 77TH AVE STE 275",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626857",
            "telephone_number": "360-567-8466",
            "fax_number": "660-951-7859"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7100 Guilford Dr # 2071",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217045257",
            "country_code": "US",
            "telephone_number": "360-567-8466",
            "fax_number": "660-951-7859",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "NADINE",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-13",
        "last_updated": "2026-03-10",
        "certification_date": "2026-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201703459NP-PP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "C-APN.0003490-C-NP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "60717374",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "NP95001782",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MD",
            "license": "R146902",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R146902",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.