Individual provider Active NPI

Annelisa Tornberg, RN, BSN, IBCLC

  • Registered Nurse
  • Seattle, WA
National Provider Identifier
1427564392
Registry record updated Dec 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN00166032 Issued in WA
Practice address
2124 4TH Ave
Seattle, WA 98121-2308
Phone
(206) 447-8300
NPI assigned
Dec 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Registered Nurse) 163WL0100X L-65574 WA
Registered Nurse 163W00000X RN00166032 WA Primary

Addresses

Primary practice location

2124 4TH Ave
Seattle, WA 98121-2308

Mailing address

6709 13TH Ave NW
Seattle, WA 98117-5334
Phone (425) 985-3185

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
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN00166032WAMDRegistered Nurse
L-65574WAMDLactation Consultant (Registered Nurse)

NPI Registry JSON

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

{
    "created_epoch": "1513209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513209600000",
    "number": "1427564392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6709 13TH AVE NW",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981175334",
            "telephone_number": "425-985-3185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2124 4TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981212308",
            "telephone_number": "206-447-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TORNBERG",
        "first_name": "ANNELISA",
        "credential": "RN, BSN, IBCLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-14",
        "last_updated": "2017-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "WA",
            "license": "L-65574",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN00166032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2017; 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.