Individual provider Active NPI

Michelle Ann Taylor

  • Psychiatric/Mental Health Nurse Practitioner
  • Othello, WA
National Provider Identifier
1386007409
Registry record updated Feb 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP60742067 Issued in WA
Practice address
1515 E Columbia St
Othello, WA 99344-1846
Phone
(509) 488-5256
Fax
(509) 488-9939
NPI assigned
Apr 5, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP60742067 WA Primary

Addresses

Primary practice location

1515 E Columbia St
Othello, WA 99344-1846

Mailing address

1515 E Columbia St
Othello, WA 99344-1846
Phone (509) 488-5256

Other identifiers 1

IdentifierTypeStateIssuer
2078876MedicaidWA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20170711001848 WA Practitioner - Nurse Practitioner 7517257819 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Columbia Basin Health AssociationGroup PAC ID 4486564309, 44 clinicians

Practice addresses (Care Compare)

1515 E Columbia St
Othello, WA 99344-1846
Phone 50948852568512

601 Government Way
Mattawa, WA 99349
Phone 50948852568512

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Basin Health Association Psychiatric/Mental Health CurrentSince Jul 1, 2017 Accepting new patients
Bridgeway Center Inc CurrentSince Sep 28, 2025 Accepting new patients
Columbia Basin Health Association Current Accepting new patients
Columbia Basin Health Association CurrentSince Jul 1, 2017 Accepting new patients

Locations

137 Hospital Dr NE
Ft Walton Bch, FL 32548
Phone (850) 226-8857

205 Shell Ave SE
Ft Walton Bch, FL 32548
Phone (850) 244-0151

601 Government Rd
Mattawa, WA 99349
Phone 5094885256 ext. 8512

475 N 14th Ave
Othello, WA 99344
Phone (425) 823-4000

1515 E Columbia St
Othello, WA 99344
Phone (509) 488-5250

Organizations & group practices 4

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": "1459814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581897600000",
    "number": "1386007409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 E COLUMBIA ST",
            "city": "OTHELLO",
            "state": "WA",
            "postal_code": "993441846",
            "telephone_number": "509-488-5256",
            "fax_number": "509-488-9939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 E COLUMBIA ST",
            "city": "OTHELLO",
            "state": "WA",
            "postal_code": "993441846",
            "telephone_number": "509-488-5256",
            "fax_number": "509-488-9939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "MICHELLE",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-05",
        "last_updated": "2020-02-17",
        "certification_date": "2020-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP60742067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2078876",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Othello, WA

Sources for this page

Verify at the official NPI Registry.