Individual provider Active NPI

Mark Alden Funelas Bueno

  • Registered Nurse
  • Kenmore, WA
National Provider Identifier
1538024674
Registry record updated Dec 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
61117253 Issued in WA
Practice address
7719 NE 148TH PL
Kenmore, WA 98028-4751
Phone
(425) 894-4810
NPI assigned
Dec 22, 2025
Sex
Male
Sole proprietor
Yes

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

State licenses

LicenseStateTypeSpecialty
61117253WAMDRegistered Nurse

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 61117253 WA Primary

Addresses

NPPES NPI Registry

Primary practice location

7719 NE 148TH PL
Kenmore, WA 98028-4751

Mailing address

7719 NE 148TH PL
Kenmore, WA 98028-4751
Phone (425) 894-4810

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 22, 2025.

{
    "created_epoch": "1766361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766361600000",
    "number": "1538024674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7719 NE 148TH PL",
            "city": "KENMORE",
            "state": "WA",
            "postal_code": "980284751",
            "telephone_number": "425-894-4810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7719 NE 148TH PL",
            "city": "KENMORE",
            "state": "WA",
            "postal_code": "980284751",
            "telephone_number": "425-894-4810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUENO",
        "first_name": "MARK ALDEN",
        "middle_name": "FUNELAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-12-22",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "61117253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenmore, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2025; 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.