NPIMap

Organization Active NPI

Wapato Creek Health and Wellness, Inc.

  • Psychiatric/Mental Health Nurse Practitioner
  • Fife, WA
National Provider Identifier
1245999655
Registry record updated Dec 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
WAPATO CREEK HEALTH AND WELLNESS, INC.
Practice address
3203 Wilton LN E
Fife, WA 98424-2315
Phone
(253) 533-5768
Fax
(866) 638-7530
NPI assigned
Dec 13, 2021
Last updated
Dec 13, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2021

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

Authorized official

Name
Dr. Adrianne Marie Papoff-Wallace, ARNPNPI 1366911679
Title
Owner, Arnp
Phone
(253) 533-5768

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

3203 Wilton LN E
Fife, WA 98424-2315

Mailing address

3203 Wilton LN E
Fife, WA 98424-2315
Phone (253) 533-5768

Other practice location 1

821 N St Ste 102
Anchorage, AK 99501-3285
Phone (253) 533-5768

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211215003000 WA Part B Supplier - Clinic/Group Practice 1557752110 Receives reassigned benefits from 7 practitioners
Practice locations: Fife, WA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1639353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639353600000",
    "number": "1245999655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3203 WILTON LN E",
            "city": "FIFE",
            "state": "WA",
            "postal_code": "984242315",
            "telephone_number": "253-533-5768",
            "fax_number": "866-638-7530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3203 WILTON LN E",
            "city": "FIFE",
            "state": "WA",
            "postal_code": "984242315",
            "telephone_number": "253-533-5768",
            "fax_number": "866-638-7530"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "821 N St Ste 102",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995013285",
            "country_code": "US",
            "telephone_number": "253-533-5768",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WAPATO CREEK HEALTH AND WELLNESS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-13",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A",
        "authorized_official_last_name": "PAPOFF-WALLACE",
        "authorized_official_first_name": "ADRIANNE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER, ARNP",
        "authorized_official_telephone_number": "253-533-5768",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fife, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.