Organization Active NPI

Greenbridge Health Clinic

  • Psychiatric/Mental Health Nurse Practitioner
  • Kennewick, WA
National Provider Identifier
1386473551
Registry record updated Jan 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
GREENBRIDGE HEALTH CLINIC
Practice address
4256 W 24TH Ave
Ste 101
Kennewick, WA 99338-7171
Phone
(509) 802-3664
NPI assigned
Jul 29, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2025

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

Authorized official

Name
Miriam Okochi, ARNPNPI 1184305062
Title
Pmhnp
Phone
(708) 916-5798

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

4256 W 24TH Ave
Ste 101
Kennewick, WA 99338-7171

Mailing address

2560 Casa Bella Ave
Richland, WA 99352-5527
Phone (708) 916-5798

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241113001571 WA Part B Supplier - Clinic/Group Practice 1052845005 Receives reassigned benefits from 2 practitioners
Practice locations: Kennewick, WA; Richland, WA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D2317102Greenbridge Health Clinic4256 W 24TH Ave Ste 101, Kennewick, WA 99338Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory

Locations

4256 W 24th Ave
Ste 101
Kennewick, WA 99338
Phone (509) 802-3664

1360 N Louisiana St
#A721
Kennewick, WA 99336

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1722211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737158400000",
    "number": "1386473551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2560 CASA BELLA AVE",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993525527",
            "telephone_number": "708-916-5798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4256 W 24TH AVE",
            "address_2": "STE 101",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993387171",
            "telephone_number": "509-802-3664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENBRIDGE HEALTH CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-29",
        "last_updated": "2025-01-18",
        "certification_date": "2025-01-18",
        "status": "A",
        "authorized_official_last_name": "OKOCHI",
        "authorized_official_first_name": "MIRIAM",
        "authorized_official_title_or_position": "PMHNP",
        "authorized_official_telephone_number": "708-916-5798",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennewick, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.