Active NPI
Martha Wahu Mburu, ARNP, PMHNP, FNP-C
- Psychiatric/Mental Health Nurse Practitioner
- Bonney Lake, WA
National Provider Identifier
1205334927
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- RN61267437
- Practice address
- 15416 205TH Ave E
Bonney Lake, WA 98391-5568 - Phone
- (574) 707-5898
- NPI assigned
- Jan 28, 2018
- Last updated
- Jul 29, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 223599901 | Medicaid | WA | |
| AP61268540 | Other | WA | DOH |
| RN61267437 | Other | WA | DOH |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240711001225 | WA | Practitioner - Nurse Practitioner | 7012263825 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN61267437 | WA | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dativa Body and Mind Healthcare PLLC | Current | Accepting new patients | |
| Safi Adult Family Home LLC | Registered Nurse | Current | 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.
-
- Registered Nurse
- Bonney Lake, WA
- NPI 1710677364
-
- Family Nurse Practitioner
- Federal Way, WA
- NPI 1669233961
-
- Family Medicine Physician
- Spokane, WA
- NPI 1376399774
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.