Individual provider Active NPI

Anita Rajwan, NP

  • Nurse Practitioner
  • Everett, WA
National Provider Identifier
1437626231
Registry record updated Nov 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP60786413 Issued in WA
Practice address
1700 13TH St
Everett, WA 98201-1689
Phone
(425) 404-5345
NPI assigned
Oct 30, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP60786413 WA
Nurse Practitioner 363L00000X AP60786413 WA Primary

Addresses

Primary practice location

1700 13TH St
Everett, WA 98201-1689

Mailing address

PO Box 3360
Portland, OR 97208-3360
Phone (866) 747-2455

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
I20190205002034 WA Practitioner - Nurse Practitioner 2163760802 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1700 13TH St
Everett, WA 98201-1689
Phone (425) 261-3968

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP60786413WAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services-Wa CurrentSince Nov 12, 2018 Accepting new patients
Providence Health & Services-Washington CurrentSince Nov 12, 2018 Accepting new patients
Providence Health & Services-Wa Current Accepting new patients
Providence Health & Services-Wa Nurse Practitioner Past Accepting new patients

Locations

900 Pacific Ave
Fl 5
Everett, WA 98201
Phone (425) 258-7311

1700 13th St
Everett, WA 98201
Phone (425) 252-0895

1321 Colby Ave
Ofc
Everett, WA 98201
Phone (425) 261-4076

1321 Colby Ave
Everett, WA 98201
Phone (425) 259-4413

4112 Harbour Pointe Blvd SW
Ste 100
Mukilteo, WA 98275
Phone (425) 347-6330

Organizations & group practices 4

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1540857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541462400000",
    "number": "1437626231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3360",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083360",
            "telephone_number": "866-747-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 13TH ST",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982011689",
            "telephone_number": "425-404-5345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJWAN",
        "first_name": "ANITA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-30",
        "last_updated": "2018-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60786413",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP60786413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.