Individual provider Active NPI

Margaret Ann Rose, ARNP, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Vancouver, WA
National Provider Identifier
1346510161
Registry record updated Oct 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP30002884 Issued in WA
Practice address
720 NE 160TH Ave Ste #103 PMB #305
Vancouver, WA 98684
Phone
(206) 719-8870
Fax
(360) 838-0310
NPI assigned
Jan 10, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP30002884 WA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP30002884 WA Primary

Addresses

Primary practice location

720 NE 160TH Ave Ste #103 PMB #305
Vancouver, WA 98684

Mailing address

720 NE 160TH Ave Ste #103 PMB #305
Vancouver, WA 98684
Phone (206) 719-8870

Other identifiers 2

IdentifierTypeStateIssuer
1346510161Other1346510161
1346510161OtherWA1346510161

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
I20050315000450 WA Practitioner - Nurse Practitioner 1951356773 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP30002884WAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Telecare Mental Health Services of Washington, Inc. CurrentSince Jul 15, 2016 Accepting new patients
Telecare Mental Health Services of Washington, Inc Current Accepting new patients
Telecare Mental Health Services of Washington Inc CurrentSince Jul 15, 2016 Accepting new patients
Shifa Health PLLC PastSince Mar 14, 2003 Accepting new patients
Cascade Psychiatric Services, PLLC Past Accepting new patients

Locations

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

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

Organizations & group practices 5

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": "1326153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1346510161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 NE 160TH AVE STE #103 PMB #305",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98684",
            "telephone_number": "206-719-8870",
            "fax_number": "360-838-0310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 NE 160TH AVE STE #103 PMB #305",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98684",
            "telephone_number": "206-719-8870",
            "fax_number": "360-838-0310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "MARGARET",
        "middle_name": "ANN",
        "credential": "ARNP, PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-10",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP30002884",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP30002884",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1346510161",
            "identifier": "1346510161",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1346510161",
            "identifier": "1346510161",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.