Individual provider Active NPI

Alimatou Moustapha, ARNP, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Lakewood, WA
National Provider Identifier
1316588619
Registry record updated Oct 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP60702851 Issued in WA
Practice address
9601 Steilacoom Blvd SW
Lakewood, WA 98498-7212
Phone
(253) 582-8900
NPI assigned
Oct 8, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP60702851 WA Primary

Addresses

Primary practice location

9601 Steilacoom Blvd SW
Lakewood, WA 98498-7212

Mailing address

26236 33Rd Ave S
Kent, WA 98032-7055
Phone (206) 683-0540

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
I20200317000417 WA Practitioner - Nurse Practitioner 3072941582 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Lakes Mental Health Foundation Inc CurrentSince Feb 1, 2021 Accepting new patients
Telecare Mental Health Services of Washington Inc CurrentSince Nov 1, 2022 Accepting new patients
Telecare Mental Health Services of Washington, Inc Current Accepting new patients
Telecare Mental Health Services of Washington, Inc. CurrentSince Nov 1, 2022 Accepting new patients

Locations

1080 Marina Village Pkwy
Ste 100
Alameda, CA 94501
Phone (510) 306-5660

322 S Birch St
McCleary, WA 98557
Phone (360) 205-4750

9601 Steilacoom Blvd SW
Bldg 27
Tacoma, WA 98498
Phone (253) 589-5334

9330 59th Ave SW
Tacoma, WA 98499
Phone (253) 581-7020

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1570492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570492800000",
    "number": "1316588619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26236 33RD AVE S",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980327055",
            "telephone_number": "206-683-0540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9601 STEILACOOM BLVD SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984987212",
            "telephone_number": "253-582-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUSTAPHA",
        "first_name": "ALIMATOU",
        "name_prefix": "Ms.",
        "credential": "ARNP, PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-08",
        "last_updated": "2019-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP60702851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, WA

Sources for this page

Verify at the official NPI Registry.