Individual provider Active NPI

Tara Martell, ARNP

  • Family Nurse Practitioner
  • Richland, WA
National Provider Identifier
1487319091
Registry record updated Nov 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
6123129 Issued in WA
Practice address
2177 Cascade Ave
Richland, WA 99354-1867
Phone
(509) 528-8177
NPI assigned
Nov 8, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 6123129 WA Primary

Addresses

Primary practice location

2177 Cascade Ave
Richland, WA 99354-1867

Mailing address

2177 Cascade Ave
Richland, WA 99354-1867
Phone (509) 528-8177

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
I20240827001204 WA Practitioner - Nurse Practitioner 0941749691 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6123129WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wa Pacs 2 PC CurrentSince Jul 8, 2024 Accepting new patients
CS Pacs 3 Northwest, LLC CurrentSince Sep 28, 2024 Accepting new patients
Washington Pac Services PC CurrentSince Jun 5, 2024 Accepting new patients

Locations

1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325

414 17th St SE
Auburn, WA 98002
Phone (253) 320-0748

21008 76th Ave W
Edmonds, WA 98026
Phone (425) 778-0107

135 S 336th St
Federal Way, WA 98003
Phone (253) 835-7433

920 12th Ave SE
Puyallup, WA 98372
Phone (253) 841-3422

3600 E Hartson Ave
Spokane, WA 99202
Phone (509) 468-7000

414 S University Rd
Spokane Valley, WA 99206
Phone (509) 924-4650

14820 E 4th Ave
Spokane Valley, WA 99216
Phone (509) 922-1644

92 Wainwright Dr
Walla Walla, WA 99362
Phone (509) 394-6800

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1636329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1487319091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2177 CASCADE AVE",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993541867",
            "telephone_number": "509-528-8177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2177 CASCADE AVE",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993541867",
            "telephone_number": "509-528-8177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTELL",
        "first_name": "TARA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-08",
        "last_updated": "2021-11-08",
        "certification_date": "2021-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "6123129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richland, WA

Sources for this page

Verify at the official NPI Registry.