NPIMap

Organization Active NPI

Spectrum Mental Health

Doing business as Kaleidoscope Rx

  • Psychiatric/Mental Health Nurse Practitioner
  • Vancouver, WA
National Provider Identifier
1356812614
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
SPECTRUM MENTAL HEALTH
Doing business as
Kaleidoscope Rx
Practice address
12503 SE Mill Plain Blvd Ste 123
Vancouver, WA 98684-4007
Phone
(360) 334-9942
Fax
(425) 242-3683
NPI assigned
Dec 16, 2018
Last updated
Sep 8, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2025

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

Authorized official

Name
Rhonda Rowan, ARNPNPI 1427568492
Title
Owner
Phone
(360) 334-9942

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

12503 SE Mill Plain Blvd Ste 123
Vancouver, WA 98684-4007

Mailing address

12503 SE Mill Plain Blvd Ste 123
Vancouver, WA 98684-4007
Phone (360) 334-9942

Other practice location 1

1200 Chesterly Dr Ste 100
Yakima, WA 98902-7339
Phone (360) 334-9942

Other names 1

  • Kaleidoscope Rx Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200625000820 WA Part B Supplier - Clinic/Group Practice 6103248851 Receives reassigned benefits from 10 practitioners
Practice locations: Vancouver, WA; Yakima, WA

National Provider Directory

National Provider Directory

Locations

108 SE 124th Ave
Ste 11
Vancouver, WA 98684
Phone (360) 334-9942

1112 Daniels St
#30
Vancouver, WA 98660

12503 SE Mill Plain Blvd
Ste 123
Vancouver, WA 98684
Phone (360) 334-9942

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757289600000",
    "number": "1356812614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12503 SE MILL PLAIN BLVD STE 123",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986844007",
            "telephone_number": "360-334-9942",
            "fax_number": "425-242-3683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12503 SE MILL PLAIN BLVD STE 123",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986844007",
            "telephone_number": "360-334-9942",
            "fax_number": "425-242-3683"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 Chesterly Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Yakima",
            "state": "WA",
            "postal_code": "989027339",
            "country_code": "US",
            "telephone_number": "360-334-9942",
            "fax_number": "425-242-3683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SPECTRUM MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-16",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A",
        "authorized_official_last_name": "ROWAN",
        "authorized_official_first_name": "RHONDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-334-9942",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kaleidoscope Rx",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.