Individual provider Active NPI

Kaberi K Dannemiller, NP

  • Pediatric Nurse Practitioner
  • Mountlake Terrace, WA
National Provider Identifier
1609107655
Registry record updated Jan 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
70015390 Issued in WA
Practice address
23511 56TH Ave W Ste 105
Mountlake Terrace, WA 98043-5285
Phone
(206) 546-2421
Fax
(206) 542-9028
NPI assigned
Jan 14, 2010
Last updated
Jan 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 70015390 WA Primary
Pediatric Nurse Practitioner 363LP0200X NP18767 CA
Pediatric Nurse Practitioner 363LP0200X APRN2724 HI

Addresses

Primary practice location

23511 56TH Ave W Ste 105
Mountlake Terrace, WA 98043-5285

Mailing address

23511 56TH Ave W Ste 105
Mountlake Terrace, WA 98043-5285
Phone (206) 546-2421

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20191122001434 HI Practitioner - Nurse Practitioner 7315230695 Reassigns benefits to 1 organization
I20260106002217 WA Practitioner - Nurse Practitioner 7315230695 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Yale University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

PO Box
Suite 5371
Seattle, WA 98145

PO Box
Suite 5371
Seattle, WA 98145-5005

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP18767CAMDPediatric Nurse Practitioner
APRN2724HIMDPediatric Nurse Practitioner
70015390WAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Clinical Education & Research Associates CurrentSince Oct 1, 2019 Accepting new patients
University Clinical Education & Research Associates CurrentSince Oct 1, 2019 Accepting new patients
Umbrella Pediatrics PC CurrentSince Oct 11, 2025 Accepting new patients
Richmond Pediatric Clinic Inc. P.S. PastSince Oct 11, 2025 Accepting new patients

Locations

98-1079 Moanalua Rd
Aiea, HI 96701
Phone (808) 485-4301

677 Ala Moana Blvd
Ste 1001
Honolulu, HI 96813

23511 56th Ave W
Ste 105
Mountlake Terrace, WA 98043
Phone (206) 546-2421

Organizations & group practices 4

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": "1263427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768435200000",
    "number": "1609107655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23511 56TH AVE W STE 105",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980435285",
            "telephone_number": "206-546-2421",
            "fax_number": "206-542-9028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23511 56TH AVE W STE 105",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980435285",
            "telephone_number": "206-546-2421",
            "fax_number": "206-542-9028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANNEMILLER",
        "first_name": "KABERI",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-14",
        "last_updated": "2026-01-15",
        "certification_date": "2026-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WA",
            "license": "70015390",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "NP18767",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "HI",
            "license": "APRN2724",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountlake Terrace, WA

Sources for this page

Verify at the official NPI Registry.