Wendy C. Imberg, ARNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP30002555 Issued in WA

Practice address

19200 N Kelsey St
Monroe, WA 98272-1431

Phone

(360) 794-7994

Fax

(360) 805-4755

NPI assigned

Sep 26, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Molina Healthcare of Washington, Inc

  • Family Medicine Physician
  • Everett, WA
  • NPI 1912235060
  Medicare reassignment NPD
• Molina Healthcare of Washington, Inc

  • Family Medicine Physician
  • Bothell, WA
  • NPI 1659897163
  NPD

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423008000000",
    "number": "1578664132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3360",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083360",
            "telephone_number": "866-366-2983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19200 N KELSEY ST",
            "city": "MONROE",
            "state": "WA",
            "postal_code": "982721431",
            "telephone_number": "360-794-7994",
            "fax_number": "360-805-4755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMBERG",
        "first_name": "WENDY",
        "middle_name": "C.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2015-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP30002555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9611518",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan Charles Huotari
• Daniel Nelson Hurne, N.D.
• Pamela Hyvonen, BSN, RN
• Idaho Falls Vision Center Chartered
• Ideal Option, PLLC
• Integral Element LLC (Integral Element Natural Medicine)
• Integrated Rehabilitation Group, PC (Northwest Sport & Spine Physical Therapy- Monroe)
• Kelly Rae Irwin, DMD
• Jessica Isono, PHARM.D.
• Siri Eiko Ito, MD

• Nurse Practitioner in Monroe, WA
• Providers in Monroe, WA by specialty
• Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.