Individual provider Active NPI

Martha Wahu Mburu, ARNP, PMHNP, FNP-C

  • Psychiatric/Mental Health Nurse Practitioner
  • Bonney Lake, WA
National Provider Identifier
1205334927
Registry record updated Jul 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN61267437 Issued in WA
Practice address
15416 205TH Ave E
Bonney Lake, WA 98391-5568
Phone
(574) 707-5898
NPI assigned
Jan 28, 2018
Last updated
Jul 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 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 61267437 WA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN61267437 WA Primary

Addresses

Primary practice location

15416 205TH Ave E
Bonney Lake, WA 98391-5568

Mailing address

15416 205TH Ave E
Bonney Lake, WA 98391-5568
Phone (574) 707-5898

Other practice location 1

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

Other identifiers 3

IdentifierTypeStateIssuer
223599901MedicaidWA
AP61268540OtherWADOH
RN61267437OtherWADOH

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
I20240711001225 WA Practitioner - Nurse Practitioner 7012263825

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN61267437WAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Dativa Body and Mind Healthcare PLLC CurrentSince Jun 1, 2024 Accepting new patients
Safi Adult Family Home LLC Registered Nurse CurrentSince Sep 3, 2025 Accepting new patients

Locations

32700 Pacific Hwy S
Ste 11
Federal Way, WA 98003
Phone (253) 448-7411

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1517097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785283200000",
    "number": "1205334927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15416 205TH AVE E",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983915568",
            "telephone_number": "574-707-5898",
            "fax_number": "253-448-7411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15416 205TH AVE E",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983915568",
            "telephone_number": "574-707-5898"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 S Grady Way Ste 249",
            "address_purpose": "LOCATION",
            "city": "Renton",
            "state": "WA",
            "postal_code": "980573209",
            "country_code": "US",
            "telephone_number": "425-233-0431",
            "fax_number": "425-329-8087",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MBURU",
        "first_name": "MARTHA",
        "middle_name": "WAHU",
        "credential": "ARNP, PMHNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-28",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "61267437",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "RN61267437",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "223599901",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOH",
            "identifier": "AP61268540",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOH",
            "identifier": "RN61267437",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonney Lake, WA

Sources for this page

Verify at the official NPI Registry.