Individual provider Active NPI

Irena Alexandra Wright, ARNP

  • Family Nurse Practitioner
  • Puyallup, WA
National Provider Identifier
1508829367
Registry record updated Oct 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP30005672 Issued in WA
Practice address
1011 E Main Ave
Suite 302
Puyallup, WA 98372-6775
Phone
(253) 841-2471
Fax
(253) 841-2472
NPI assigned
Apr 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2007

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 AP30005672 WA Primary

Addresses

Primary practice location

1011 E Main Ave
Suite 302
Puyallup, WA 98372-6775

Mailing address

1011 Main Ave E
Ste 302
Puyallup, WA 98372-6775
Phone (253) 841-2471

Other identifiers 1

IdentifierTypeStateIssuer
9630880MedicaidWA

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

State licenses

LicenseStateTypeSpecialty
AP30005672WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Digestive Health Specialists PS Past Accepting new patients
Puyallup Endocrine & Nuclear Medicine Clinics PastSince Nov 16, 2015 Accepting new patients

Organizations & group practices 2

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": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193356800000",
    "number": "1508829367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 MAIN AVE E",
            "address_2": "STE 302",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983726775",
            "telephone_number": "253-841-2471",
            "fax_number": "253-841-2472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 E MAIN AVE",
            "address_2": "SUITE 302",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983726775",
            "telephone_number": "253-841-2471",
            "fax_number": "253-841-2472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "IRENA",
        "middle_name": "ALEXANDRA",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-11",
        "last_updated": "2007-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP30005672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9630880",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2007; 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.