Individual provider Active NPI

Candie M. Wellwood, DNP, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Medical Lake, WA
National Provider Identifier
1386254290
Registry record updated Dec 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP61025826 Issued in WA
Practice address
731 N Stanley St
Medical Lake, WA 99022-8940
Phone
(509) 299-6900
Fax
(509) 351-2818
NPI assigned
Aug 5, 2020
Last updated
Dec 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2025

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 AP61025826 WA Primary

Addresses

Primary practice location

731 N Stanley St
Medical Lake, WA 99022-8940

Mailing address

731 N Stanley St
Medical Lake, WA 99022-8940
Phone (509) 299-6900

Other names 1

  • Candie M Johnson Former name

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
I20200827000940 WA Practitioner - Nurse Practitioner 9133546708 Reassigns benefits to 1 organization
Practice locations: Medical Lake, WA

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Natural Health Ctr of Med Lake PSGroup PAC ID 2567464696, 9 clinicians

Practice addresses (Care Compare)

731 N Stanley St
Medical Lake, WA 99022-8940
Phone (509) 299-6900

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Natural Health Ctr of Med Lake PS Psychiatric/Mental Health CurrentSince Aug 13, 2023 Accepting new patients
Essential Psychiatry, PLLC Psychiatric/Mental Health CurrentSince Dec 8, 2020 Accepting new patients

Locations

731 N Stanley St
Medical Lake, WA 99022
Phone (509) 299-6900

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1596585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765843200000",
    "number": "1386254290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 N STANLEY ST",
            "city": "MEDICAL LAKE",
            "state": "WA",
            "postal_code": "990228940",
            "telephone_number": "509-299-6900",
            "fax_number": "509-299-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 N STANLEY ST",
            "city": "MEDICAL LAKE",
            "state": "WA",
            "postal_code": "990228940",
            "telephone_number": "509-299-6900",
            "fax_number": "509-351-2818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLWOOD",
        "first_name": "CANDIE",
        "middle_name": "M.",
        "credential": "DNP, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-05",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61025826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CANDIE",
            "last_name": "JOHNSON",
            "middle_name": "M",
            "credential": "DNP, PMHNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Medical Lake, WA

Sources for this page

Verify at the official NPI Registry.