Individual provider Active NPI

Miriam Carla Sorensen, FNP

  • Nurse Practitioner
  • Mukilteo, WA
National Provider Identifier
1376914879
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP60499123 Issued in WA
Practice address
10200 Mukilteo Speedway
Mukilteo, WA 98275
Phone
(888) 227-3312
NPI assigned
Oct 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP60499123 WA Primary
Family Nurse Practitioner 363LF0000X AP60499123 WA

Addresses

Primary practice location

10200 Mukilteo Speedway
Mukilteo, WA 98275

Mailing address

PO Box 3360
Portland, OR 97208-3360
Phone (866) 747-2455

Other practice location 1

982 E Columbia Ave
Colville, WA 99114-3316
Phone (509) 684-3701 ext. 7761

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address msorensen951172@wm.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20151214000272 WA Practitioner - Nurse Practitioner 3678874898 Reassigns benefits to 3 organizations
I20230907001426 OR Practitioner - Nurse Practitioner 3678874898 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Express Care Wa PCGroup PAC ID 6800128067, 64 clinicians
Express Care Or PCGroup PAC ID 1254768732, 60 clinicians

Practice addresses (Care Compare)

105 E Mission Ave
Suite D
Spokane, WA 99202-6002
Phone (888) 227-3312

13110 Bothell Everett Hwy
Everett, WA 98208-7202
Phone (425) 525-6329

1350 Marvin Rd NE
Suite D
Lacey, WA 98516-3877
Phone (888) 227-3312

1601 George Washington Way
Richland, WA 99354-2626
Phone (888) 227-3312

718 91St Ave NE
Lake Stevens, WA 98258-2420
Phone (888) 227-3312

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP60499123WAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services- Washington CurrentSince Aug 27, 2018 Accepting new patients
Providence Health & Services - Washington CurrentSince Aug 27, 2018 Accepting new patients
Express Care Or PC CurrentSince Aug 23, 2023 Accepting new patients
Express Care Wa PC CurrentSince Jan 1, 2020 Accepting new patients
Providence Health & Services - Washington Past Accepting new patients

Locations

1336 NE Orenco Station Pkwy
Hillsboro, OR 97124

1840 E Portland Rd
Newberg, OR 97132
Phone (503) 538-9360

4400 NE Halsey St
#2
Portland, OR 97213
Phone (503) 893-6472

4400 NE Halsey St
Bldg 23
Portland, OR 97213
Phone (855) 299-6460

1321 Colby Ave
Ofc
Everett, WA 98201
Phone (425) 261-4076

13110 Bothell Everett Hwy
Everett, WA 98208
Phone (425) 379-7274

1350 Marvin Rd NE
Ste D
Lacey, WA 98516
Phone (360) 456-2008

718 91st Ave NE
Lake Stevens, WA 98258
Phone (425) 334-1523

10200 Mukilteo Speedway
Mukilteo, WA 98275
Phone (425) 315-9213

4112 Harbour Pointe Blvd SW
Ste 100
Mukilteo, WA 98275
Phone (425) 347-6330

10258 W Sunset Hwy
Ste 6
Spokane, WA 99224

Interoperability endpoints

  • Direct secure messaging: msorensen951172@wm.providencedirect.org

Organizations & group practices 5

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": "1444348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1376914879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3360",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083360",
            "telephone_number": "866-747-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10200 MUKILTEO SPEEDWAY",
            "city": "MUKILTEO",
            "state": "WA",
            "postal_code": "98275",
            "telephone_number": "888-227-3312"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "982 E Columbia Ave",
            "address_purpose": "LOCATION",
            "city": "Colville",
            "state": "WA",
            "postal_code": "991143316",
            "country_code": "US",
            "telephone_number": "509-684-3701 x7761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SORENSEN",
        "first_name": "MIRIAM",
        "middle_name": "CARLA",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-09",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP60499123",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60499123",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "msorensen951172@wm.providencedirect.org",
            "affiliation": "N",
            "address_1": "13110 Bothell Everett Hwy",
            "city": "Everett",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982087202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mukilteo, WA

Sources for this page

Verify at the official NPI Registry.