Individual provider Active NPI

Amanda Marie Deardorff, CNM, ARNP

  • Advanced Practice Midwife
  • Seattle, WA
National Provider Identifier
1225326465
Registry record updated Apr 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
AP60239525 Issued in WA
Practice address
2511 NE 100TH St
Seattle, WA 98125-7707
Phone
(425) 366-7563
Fax
(425) 671-0360
NPI assigned
Jul 20, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X AP60239525 WA Primary

Addresses

Primary practice location

2511 NE 100TH St
Seattle, WA 98125-7707

Mailing address

8401 5TH Ave NE Ste 102
Seattle, WA 98115-4171
Phone (425) 366-7563

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
AP60239525WAMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Healthy Woman Seattle Past Accepting new patients

Organizations & group practices 1

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": "1311120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365552000000",
    "number": "1225326465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8401 5TH AVE NE STE 102",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981154171",
            "telephone_number": "425-366-7563",
            "fax_number": "425-671-0360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2511 NE 100TH ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981257707",
            "telephone_number": "425-366-7563",
            "fax_number": "425-671-0360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEARDORFF",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "credential": "CNM, ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-20",
        "last_updated": "2013-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "WA",
            "license": "AP60239525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.