Individual provider Active NPI

Mackenzie Rae Weiland, MSN, WHNP-BC

  • Women's Health Nurse Practitioner
  • Everett, WA
National Provider Identifier
1376294389
Registry record updated Jan 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
AP61258631 Issued in WA
Practice address
1509 32ND St
Everett, WA 98201-4302
Phone
(800) 769-0045
NPI assigned
Jan 11, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN61239218 WA
Registered Nurse 163W00000X RN297783 GA
Women's Health Nurse Practitioner 363LW0102X AP61258631 WA Primary

Addresses

Primary practice location

1509 32ND St
Everett, WA 98201-4302

Mailing address

17202 Aurora Ave N Apt 223
Shoreline, WA 98133-5354
Phone (502) 715-2696

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
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN297783GAMDRegistered Nurse
RN61239218WAMDRegistered Nurse
AP61258631WAMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Planned Parenthood Great Northwest, Hawai'I, Alaska, Indiana, Kentucky PastSince Jan 21, 2022 Accepting new patients
Planned Parenthood Great Northwest, Hawai'I, Alaska, Indiana, Kentucky PastSince Jan 21, 2022 Accepting new patients
Planned Parenthood Great Northwest, Hawai'I, Alaska, Indiana, Kentucky Women'S Health Past Accepting new patients

Organizations & group practices 3

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": "1641859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642118400000",
    "number": "1376294389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17202 AURORA AVE N APT 223",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981335354",
            "telephone_number": "502-715-2696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 32ND ST",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014302",
            "telephone_number": "800-769-0045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEILAND",
        "first_name": "MACKENZIE",
        "middle_name": "RAE",
        "credential": "MSN, WHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-11",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN61239218",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN297783",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "WA",
            "license": "AP61258631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.