Active NPI
Delores Mack, RN
- Registered Nurse
- Des Moines, WA
National Provider Identifier
1407481807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN60573114
- Practice address
- 26401 Pacific Hwy S
Des Moines, WA 98198-9247 - Phone
- (206) 586-2583
- NPI assigned
- Mar 5, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN60573114 | WA | Primary |
Addresses
Primary practice location
26401 Pacific Hwy S
Des Moines, WA 98198-9247
Mailing address
400 5TH Ave
Suite 1000
Seattle, WA 98104
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
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN60573114 | WA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583366400000",
"number": "1407481807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 5TH AVE",
"address_2": "SUITE 1000",
"city": "SEATTLE",
"state": "WA",
"postal_code": "98104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26401 PACIFIC HWY S",
"city": "DES MOINES",
"state": "WA",
"postal_code": "981989247",
"telephone_number": "206-586-2583"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACK",
"first_name": "DELORES",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-05",
"last_updated": "2020-03-05",
"certification_date": "2020-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WA",
"license": "RN60573114",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Des Moines, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.