NPIMap

Organization Active NPI

Tacoma Integrative Psychiatry PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • University Place, WA
National Provider Identifier
1255117289
Registry record updated Jan 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
TACOMA INTEGRATIVE PSYCHIATRY PLLC
Practice address
3560 Bridgeport Way W Ste 1-D
University Place, WA 98466-4446
Phone
(253) 260-6754
Fax
(877) 725-4332
NPI assigned
Sep 5, 2023
Last updated
Jan 20, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2025

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

Authorized official

Name
Laura Walker, ARNPNPI 1548863012
Title
Owner
Phone
(253) 260-6754

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 Primary

Addresses

Primary practice location

3560 Bridgeport Way W Ste 1-D
University Place, WA 98466-4446

Mailing address

522 W Riverside Ave Ste N
Spokane, WA 99201-0580

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250306003017 WA Part B Supplier - Clinic/Group Practice 9133640162 Receives reassigned benefits from 1 practitioner
Practice locations: University Place, WA

National Provider Directory

National Provider Directory

Locations

3560 Bridgeport Way W
Ste 2C
University Place, WA 98466
Phone (253) 460-7248

Practitioners & affiliated clinicians

Practitioners 49

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.

View all 49

NPI Registry JSON

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

{
    "created_epoch": "1693872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737331200000",
    "number": "1255117289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 W RIVERSIDE AVE STE N",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992010580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3560 BRIDGEPORT WAY W STE 1-D",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984664446",
            "telephone_number": "253-260-6754",
            "fax_number": "877-725-4332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TACOMA INTEGRATIVE PSYCHIATRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-05",
        "last_updated": "2025-01-20",
        "certification_date": "2025-01-20",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-260-6754",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in University Place, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2025; 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.