Judith E. Stacey-Robar, ARNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP30006451 Issued in WA

Practice address

1851 Central PL S
Suite 123
Kent, WA 98030-7514

Phone

(253) 520-3060

Fax

(253) 859-0043

NPI assigned

Dec 30, 2006

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

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1167436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346306404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10041 SE 220TH ST",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980312509",
            "telephone_number": "253-520-7086",
            "fax_number": "253-859-0043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1851 CENTRAL PL S",
            "address_2": "SUITE 123",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980307514",
            "telephone_number": "253-520-3060",
            "fax_number": "253-859-0043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACEY-ROBAR",
        "first_name": "JUDITH",
        "middle_name": "E.",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP30006451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9638511",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREMERA BLUE CROSS",
            "identifier": "227130100000",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PACIFICARE BEHAVIORAL HEA",
            "identifier": "8307-01",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "5240ST",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0007266542",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Rachael Lynn St. Clair, LMHC
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• Stadnik and Associates
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• Ellie Stannard

• Psychiatric/Mental Health Nurse Practitioner in Kent, WA
• Providers in Kent, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.