Adrianne Papoff-Wallace, ARNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP61173244 Issued in WA

Practice address

3203 Wilton LN E
Fife, WA 98424-2315

Phone

(253) 533-5768

Fax

(866) 638-7530

NPI assigned

Nov 15, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Wapato Creek Health and Wellness, Inc.Group PAC ID 1557752110, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Wapato Creek Health and Wellness, Inc.

  • Psychiatric/Mental Health Nurse Practitioner
  • Fife, WA
  • NPI 1245999655
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1542240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1366911679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3203 WILTON LN E",
            "city": "FIFE",
            "state": "WA",
            "postal_code": "984242315",
            "telephone_number": "253-533-5768",
            "fax_number": "866-638-7530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3203 WILTON LN E",
            "city": "FIFE",
            "state": "WA",
            "postal_code": "984242315",
            "telephone_number": "253-533-5768",
            "fax_number": "866-638-7530"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2150 Freeman Rd E Ste 1",
            "address_purpose": "LOCATION",
            "city": "Fife",
            "state": "WA",
            "postal_code": "984243776",
            "country_code": "US",
            "telephone_number": "253-922-7833",
            "fax_number": "253-922-7611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAPOFF-WALLACE",
        "first_name": "ADRIANNE",
        "name_prefix": "Dr.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-15",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61173244",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "WA",
            "license": "RN60618226",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northwest Kidney Centers
• Occupational Medical Clinic of Tacoma, Inc.,PS
• Jim Ogle
• Richard Eiichi Ojima, M.D.
• Cynthia Ann Olmstead, C.O.T.A.
• Amanda L Parker, RN
• Eden Patterson
• Craig Peterson, N.D. LAC
• Loan Vu Minh Pham, DNP
• Mary Elizabeth Platt, D.O.

• Psychiatric/Mental Health Nurse Practitioner in Fife, WA
• Providers in Fife, 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 Sep 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.