Santi Wibawantini, MA, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LF60637556 Issued in WA

Practice address

2930 Maple St
Everett, WA 98201-3832

Phone

(888) 287-2680

NPI assigned

Nov 15, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: swibawantini4146819@ghc.direct-ci.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Seattle, WA
  • NPI 1396810701
  Medicare reassignment NPD
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Everett, WA
  • NPI 1386935351
  NPD

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1295079390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5508 234TH ST SW",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980434746",
            "telephone_number": "425-448-8094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2930 MAPLE ST",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982013832",
            "telephone_number": "888-287-2680"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5508 234th St SW",
            "address_purpose": "LOCATION",
            "city": "Mountlake Terrace",
            "state": "WA",
            "postal_code": "980434746",
            "country_code": "US",
            "telephone_number": "425-245-3772",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIBAWANTINI",
        "first_name": "SANTI",
        "name_prefix": "Mrs.",
        "credential": "MA, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-15",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "LF60637556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natavia Shaday Whitfield
• David Whitmore, LAT, ATC
• Myla Marie Whitney, BS, AACR
• Patsy L Whitright, OT
• Sadie A Whitten, LM, CPM
• Katy Wicks
• Kathleen Joy Widdis, CDP
• Taylor Widener, RD
• Bengt Olov Widlund
• Gudrun Wiebe, BA

• Marriage & Family Therapist in Everett, WA
• Providers in Everett, WA by specialty
• Marriage & Family Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2022; 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.