Dejanique Sheria Northwayde

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

2211 NE 139TH St
Vancouver, WA 98686-2742

Phone

(360) 397-1985

Fax

(360) 604-1604

NPI assigned

Mar 30, 2026

Last updated

Apr 23, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Dejanique Northwayde Other name

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1774828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776902400000",
    "number": "1285574566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9524 INTERLAKE AVE N UNIT B",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981033324",
            "telephone_number": "360-904-0244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 NE 139TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986862742",
            "telephone_number": "360-397-1985",
            "fax_number": "360-604-1604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORTHWAYDE",
        "first_name": "DEJANIQUE",
        "middle_name": "SHERIA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-30",
        "last_updated": "2026-04-23",
        "certification_date": "2026-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEJANIQUE",
            "last_name": "NORTHWAYDE",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Student in an Organized Health Care Education/Training Program in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Student in an Organized Health Care Education/Training Program in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.