Individual provider Active NPI

Maja Sophia Nelson, CRNA

  • Certified Registered Nurse Anesthetist
  • Everett, WA
National Provider Identifier
1518555952
Registry record updated Jan 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP61115601 Issued in WA
Practice address
1700 13TH St
Everett, WA 98201-1689
Phone
(425) 261-2000
NPI assigned
Dec 31, 2020
Last updated
Jan 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X AP61115601 WA Primary

Addresses

Primary practice location

1700 13TH St
Everett, WA 98201-1689

Mailing address

4612 N Ferdinand St
Tacoma, WA 98407-4413
Phone (253) 985-1213

Other identifiers 1

IdentifierTypeStateIssuer
AP61115601OtherWAWA ARNP ANESTHETIST LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL https://washington.providence.org/locations-directory/r/regional-medical-center

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210217001331 WA Practitioner - Certified Registered Nurse Anesthetist (Crna) 7911312319 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Wa Anesthesia Services, P.C. Anesthesiology CurrentSince Feb 1, 2021 Accepting new patients

Locations

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

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

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1609372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610668800000",
    "number": "1518555952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4612 N FERDINAND ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984074413",
            "telephone_number": "253-985-1213"
        },
        {
            "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": "425-261-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "MAJA",
        "middle_name": "SOPHIA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-31",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP61115601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA ARNP ANESTHETIST LICENSE",
            "identifier": "AP61115601",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://washington.providence.org/locations-directory/r/regional-medical-center",
            "affiliation": "N",
            "address_1": "1700 13th St",
            "city": "Everett",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982011689",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.