Individual provider Active NPI

Alexis Andrea Grimm, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Kennewick, WA
National Provider Identifier
1245994854
Registry record updated Jul 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP61287760 Issued in WA
Practice address
7325 W Deschutes Ave Ste C
Kennewick, WA 99336-6705
Phone
(509) 907-4693
Fax
(509) 278-9014
NPI assigned
Oct 29, 2021
Last updated
Jul 25, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2026

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 AP61287760 WA Primary

Addresses

Primary practice location

7325 W Deschutes Ave Ste C
Kennewick, WA 99336-6705

Mailing address

7325 W Deschutes Ave Ste C
Kennewick, WA 99336-6705
Phone (509) 907-4693

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jun 20, 2023 through Jun 20, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
202112082NP-PPORMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Riverwalk Psychiatry PLLC Current Accepting new patients
Heather a Bacon, PH.D., LLC PastSince Oct 1, 2021 Accepting new patients

Locations

705 Gage Blvd
Ste 100
Richland, WA 99352
Phone (509) 491-1120

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": "1635465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784937600000",
    "number": "1245994854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7325 W DESCHUTES AVE STE C",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993366705",
            "telephone_number": "509-907-4693",
            "fax_number": "509-278-9014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7325 W DESCHUTES AVE STE C",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993366705",
            "telephone_number": "509-907-4693",
            "fax_number": "509-278-9014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMM",
        "first_name": "ALEXIS",
        "middle_name": "ANDREA",
        "name_prefix": "Mrs.",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-29",
        "last_updated": "2026-07-25",
        "certification_date": "2026-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61287760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennewick, WA

Sources for this page

Verify at the official NPI Registry.