Individual provider Active NPI

Cydne J Marckmann, ARNP

  • Women's Health Nurse Practitioner
  • Puyallup, WA
National Provider Identifier
1578649679
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
AP00005497 Issued in WA
Practice address
3908 10TH St SE
Puyallup, WA 98374-2188
Phone
(253) 848-5951
Fax
(253) 864-8954
NPI assigned
Oct 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X AP00005497 WA Primary

Addresses

Primary practice location

3908 10TH St SE
Puyallup, WA 98374-2188

Mailing address

3908 10TH St SE
Puyallup, WA 98374-2188
Phone (253) 848-5951

Other identifiers 6

IdentifierTypeStateIssuer
9628025MedicaidWA
7801151OtherWAAETNA PROVIDER ID
P00120589OtherWAMEDICARE RAILROAD
0170567OtherWAL&I
8934626OtherWAL&I CVC
9838MAOtherWAREGENCE RIDER

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
I20040407000344 WA Practitioner - Nurse Practitioner 2062405871 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

315 Martin Luther King Jr Way
Tacoma, WA 98405-4234
Phone (253) 403-2130

317 Martin Luther King Jr Way
Tacoma, WA 98405-4234

317 MLK Jr Way
Multicare Social Work Serv
Tacoma, WA 98405-4234
Phone (253) 403-1126

4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP00005497WAMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System Current Accepting new patients
Multicare Health System CurrentSince Jan 23, 2017 Accepting new patients
Multicare Health System CurrentSince Jan 23, 2017 Accepting new patients
United Wound Healing Accountable Care Consultants PLLC CurrentSince Apr 1, 2022 Accepting new patients
Tacoma Emergency Care Physicians, PLLC CurrentSince Sep 1, 2016 Accepting new patients
Tacoma Emergency Care Physicians, PLLC CurrentSince Sep 1, 2016 Accepting new patients
Rockwood Clinic PS Past Accepting new patients
Multicare Health System Past Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

17700 SE 272nd St
Kent, WA 98042
Phone (253) 372-6500

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

2913 5th Ave NE
Ste 101
Puyallup, WA 98372
Phone (253) 905-0646

521 S K St
Tacoma, WA 98405
Phone (253) 403-2900

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

Organizations & group practices 8

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": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1578649679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3908 10TH ST SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983742188",
            "telephone_number": "253-848-5951",
            "fax_number": "253-864-8954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3908 10TH ST SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983742188",
            "telephone_number": "253-848-5951",
            "fax_number": "253-864-8954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCKMANN",
        "first_name": "CYDNE",
        "middle_name": "J",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-31",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "WA",
            "license": "AP00005497",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9628025",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER ID",
            "identifier": "7801151",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00120589",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "0170567",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I CVC",
            "identifier": "8934626",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE RIDER",
            "identifier": "9838MA",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.