Individual provider Active NPI

Donald R Rasmussen, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Issaquah, WA
National Provider Identifier
1417000118
Registry record updated Apr 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP30005925 Issued in WA
Practice address
455 Rainier Blvd N
#240
Issaquah, WA 98027-2807
Phone
(425) 392-8842
Fax
(425) 392-8841
NPI assigned
Jan 18, 2007
Last updated
Apr 25, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP30005925 WA Primary
Registered Nurse 163W00000X RN00126135 WA

Addresses

Primary practice location

455 Rainier Blvd N
#240
Issaquah, WA 98027-2807

Mailing address

455 Rainier Blvd N
#240
Issaquah, WA 98027-2807
Phone (425) 392-8842

Other identifiers 1

IdentifierTypeStateIssuer
9633454MedicaidWA

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)
Enrolled
Credentials
Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303689600000",
    "number": "1417000118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 RAINIER BLVD N",
            "address_2": "#240",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272807",
            "telephone_number": "425-392-8842",
            "fax_number": "425-392-8841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 RAINIER BLVD N",
            "address_2": "#240",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272807",
            "telephone_number": "425-392-8842",
            "fax_number": "425-392-8841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASMUSSEN",
        "first_name": "DONALD",
        "middle_name": "R",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2011-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP30005925",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN00126135",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9633454",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Issaquah, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.