Wyatt Roderick

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

IHS.FS.61601295 Issued in WA

Practice address

160 NW Gilman Blvd Ste 310
Issaquah, WA 98027-2549

Phone

(425) 245-5540

NPI assigned

Jul 14, 2025

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Revere Home Care

  • In Home Supportive Care Agency
  • Issaquah, WA
  • NPI 1841158581
  NPD Authorized official

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

{
    "created_epoch": "1752451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754006400000",
    "number": "1295626588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 NW GILMAN BLVD STE 310",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272549",
            "telephone_number": "206-605-8854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 NW GILMAN BLVD STE 310",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272549",
            "telephone_number": "425-245-5540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODERICK",
        "first_name": "WYATT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-07-14",
        "last_updated": "2025-08-01",
        "certification_date": "2025-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "WA",
            "license": "IHS.FS.61601295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Robinson
• Nicole Robinson, ARNP, CPNP, DNP
• Lauren Rocha, DNP, CPNP-PC
• Lewis B Rock III, M.D.
• Carsten Rode
• Hannah M Rodrigues, PA-C
• Kiley Serenity Roesch, L.M.P.
• Erin Roeter
• Callisto Rojas, DMD
• Joana Rojas

• In Home Supportive Care Agency in Issaquah, WA
• Providers in Issaquah, WA by specialty
• In Home Supportive Care Agency in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.