NPIMap

Individual provider Active NPI

Lisa M Deyoung, A-GNP-C

  • Gerontology Nurse Practitioner
  • Tacoma, WA
National Provider Identifier
1588380141
Registry record updated Jan 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
AP61371086 Issued in WA
Practice address
6002 Westgate Blvd Ste 230
Tacoma, WA 98406-2572
Phone
(253) 272-8664
Fax
(253) 779-8364
NPI assigned
Oct 17, 2022
Last updated
Jan 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X AP61371086 WA Primary

Addresses

Primary practice location

6002 Westgate Blvd Ste 230
Tacoma, WA 98406-2572

Mailing address

6002 Westgate Blvd Ste 230
Tacoma, WA 98406-2572
Phone (253) 272-8664

Other practice location 1

1112 6th Ave Ste 200
Tacoma, WA 98405-4048
Phone (253) 272-8664

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address llopez36035@fhsce.catholichealth.net Direct Franciscan Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221201002606 WA Practitioner - Nurse Practitioner 6800264458 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

6002 Westgate Blvd
Suite 230
Tacoma, WA 98406-2572
Phone (253) 761-2244

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group Current Accepting new patients
Franciscan Medical Group CurrentSince Nov 14, 2022 Accepting new patients
Franciscan Medical Group Past Accepting new patients

Locations

1112 6th Ave
Ste 200
Tacoma, WA 98405
Phone (253) 445-5750

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

6002 Westgate Blvd
Ste 230
Tacoma, WA 98406
Phone (253) 761-2244

Interoperability endpoints

  • Direct secure messaging: llopez36035@fhsce.catholichealth.net

Organizations & group practices 3

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1665964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1588380141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6002 WESTGATE BLVD STE 230",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984062572",
            "telephone_number": "253-272-8664",
            "fax_number": "253-779-8364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6002 WESTGATE BLVD STE 230",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984062572",
            "telephone_number": "253-272-8664",
            "fax_number": "253-779-8364"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1112 6th Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984054048",
            "country_code": "US",
            "telephone_number": "253-272-8664",
            "fax_number": "253-627-7880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEYOUNG",
        "first_name": "LISA",
        "middle_name": "M",
        "credential": "A-GNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-17",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WA",
            "license": "AP61371086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "llopez36035@fhsce.catholichealth.net",
            "affiliation": "Y",
            "affiliationName": "Franciscan Medical Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "6002 Westgate Blvd Ste 230",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984062572",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.