Individual provider Active NPI

Annette Anderson, PMHNP-C, FNP-C

  • Family Nurse Practitioner
  • Seattle, WA
National Provider Identifier
1255713145
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
60567280 Issued in WA
Practice address
2208 NW Market St Ste 430B
Seattle, WA 98107-4161
Phone
(206) 844-7832
Fax
(206) 466-5639
NPI assigned
Jun 26, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 60567280 WA Primary

Addresses

Primary practice location

2208 NW Market St Ste 430B
Seattle, WA 98107-4161

Mailing address

2208 NW Market St Ste 430B
Seattle, WA 98107-4161
Phone (206) 844-7832

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
I20150820011740 WA Practitioner - Nurse Practitioner 2769797604 Practice locations: Seattle, WA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60567280WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Trillium Psychiatry, PLLC Family CurrentSince Mar 19, 2023 Accepting new patients

Locations

2208 NW Market St
Ste 430B
Seattle, WA 98107
Phone (206) 495-2965

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, 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": "1435276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1255713145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2208 NW MARKET ST STE 430B",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981074161",
            "telephone_number": "206-844-7832",
            "fax_number": "206-466-5639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2208 NW MARKET ST STE 430B",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981074161",
            "telephone_number": "206-844-7832",
            "fax_number": "206-466-5639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ANNETTE",
        "name_prefix": "Mrs.",
        "credential": "PMHNP-C, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-26",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "60567280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.