Individual provider Active NPI

Marilyn Joanne Watkins, RN

  • Lactation Consultant (Registered Nurse)
  • Redmond, OR
National Provider Identifier
1346698032
Registry record updated Jun 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X
License
089003112RN Issued in OR
Practice address
5199 NW Elm Ave
Redmond, OR 97756-8898
Phone
(541) 350-6463
Fax
(541) 923-6462
NPI assigned
Jun 2, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Registered Nurse) 163WL0100X 089003112RN OR Primary

Addresses

Primary practice location

5199 NW Elm Ave
Redmond, OR 97756-8898

Mailing address

5199 NW Elm Ave
Redmond, OR 97756-8898
Phone (541) 350-6463

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
089003112RNORMDLactation Consultant (Registered Nurse)

NPI Registry JSON

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

{
    "created_epoch": "1464825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464825600000",
    "number": "1346698032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5199 NW ELM AVE",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977568898",
            "telephone_number": "541-350-6463",
            "fax_number": "541-923-6462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5199 NW ELM AVE",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977568898",
            "telephone_number": "541-350-6463",
            "fax_number": "541-923-6462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "MARILYN",
        "middle_name": "JOANNE",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-02",
        "last_updated": "2016-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "OR",
            "license": "089003112RN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2016; 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.