Individual provider Active NPI

Linda Jean Trader

  • Psychiatric/Mental Health Nurse Practitioner
  • Tacoma, WA
National Provider Identifier
1356987739
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP61322871 Issued in WA
Practice address
12180 Park Ave S
Tacoma, WA 98447-0014
Phone
(253) 535-7672
Fax
(253) 535-7590
NPI assigned
Nov 21, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP61322871 WA Primary
Emergency Registered Nurse 163WE0003X RN60905611 WA

Addresses

Primary practice location

12180 Park Ave S
Tacoma, WA 98447-0014

Mailing address

12180 Park Ave S
Tacoma, WA 98447-0014
Phone (253) 535-7672

Other practice location 1

12180 Park Ave S
Tacoma, WA 98447-0014
Phone (253) 535-7672

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN60905611WAMDEmergency Registered Nurse
AP61322871WAMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1574294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1356987739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12180 PARK AVE S",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984470014",
            "telephone_number": "253-535-7672",
            "fax_number": "253-535-7590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12180 PARK AVE S",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984470014",
            "telephone_number": "253-535-7672",
            "fax_number": "253-535-7590"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12180 Park Ave S",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984470014",
            "country_code": "US",
            "telephone_number": "253-535-7672",
            "fax_number": "253-535-7590",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRADER",
        "first_name": "LINDA",
        "middle_name": "JEAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-21",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61322871",
            "primary": true
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "WA",
            "license": "RN60905611",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2022; 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.