Individual provider Active NPI

Tamara A Iverson, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Pasco, WA
National Provider Identifier
1215579503
Registry record updated Oct 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP61199411 Issued in WA
Practice address
2715 Saint Andrews Loop
Pasco, WA 99301-3386
Phone
(509) 412-1051
NPI assigned
Oct 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP61199411 WA Primary

Addresses

Primary practice location

2715 Saint Andrews Loop
Pasco, WA 99301-3386

Mailing address

PO Box 959
Yakima, WA 98902
Phone (509) 575-4084

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
I20211008001214 WA Practitioner - Nurse Practitioner 7315345121 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Comprehensive HealthcareGroup PAC ID 7618875022, 32 clinicians

Practice addresses (Care Compare)

2715 Saint Andrews Loop
Suite C
Pasco, WA 99301-3386
Phone (509) 412-1051

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Healthcare CurrentSince Sep 13, 2021 Accepting new patients
Comprehensive Healthcare CurrentSince Sep 13, 2021 Accepting new patients

Locations

2715 Saint Andrews Loop
Ste C
Pasco, WA 99301
Phone (509) 412-1051

402 S 4th Ave
Yakima, WA 98902
Phone (509) 575-3874

Organizations & group practices 2

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": "1570492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633219200000",
    "number": "1215579503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 959",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "98902",
            "telephone_number": "509-575-4084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2715 SAINT ANDREWS LOOP",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993013386",
            "telephone_number": "509-412-1051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVERSON",
        "first_name": "TAMARA",
        "middle_name": "A",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-08",
        "last_updated": "2021-10-03",
        "certification_date": "2021-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61199411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasco, WA

Sources for this page

Verify at the official NPI Registry.