Individual provider Active NPI

Dee Dee Vasquez, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Burien, WA
National Provider Identifier
1205200201
Registry record updated Nov 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP60616150 Issued in WA
Practice address
1210 SW 136TH St
Burien, WA 98166-1214
Phone
(206) 257-6600
NPI assigned
Nov 15, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP60616150 WA Primary
Registered Nurse 163W00000X RN60363461 WA

Addresses

Primary practice location

1210 SW 136TH St
Burien, WA 98166-1214

Mailing address

1210 SW 136TH St
Burien, WA 98166-1214
Phone (206) 257-6600

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
I20160129001204 WA Practitioner - Nurse Practitioner 3577866227 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Puget Sound Psychiatric Center PSGroup PAC ID 4688766066, 5 clinicians

Practice addresses (Care Compare)

10634 E Riverside Dr
Suite 130
Bothell, WA 98011-3758
Phone (425) 806-5021

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP60616150WAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Puget Sound Psychiatric Center, PS Psychiatric/Mental Health CurrentSince Oct 1, 2019 Accepting new patients
Navos CurrentSince Jan 6, 2016 Accepting new patients
Navos CurrentSince Jan 6, 2016 Accepting new patients

Locations

10634 E Riverside Dr
Ste 130
Bothell, WA 98011
Phone (425) 806-5021

1210 SW 136th St
Burien, WA 98166
Phone (206) 257-6600

2600 SW Holden St
Seattle, WA 98126
Phone (206) 241-0990

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.

NPI Registry JSON

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

{
    "created_epoch": "1447545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447545600000",
    "number": "1205200201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 SW 136TH ST",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981661214",
            "telephone_number": "206-257-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 SW 136TH ST",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981661214",
            "telephone_number": "206-257-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASQUEZ",
        "first_name": "DEE DEE",
        "name_prefix": "Ms.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-15",
        "last_updated": "2015-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP60616150",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60363461",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burien, WA

Sources for this page

Verify at the official NPI Registry.