Individual provider Active NPI

Marla Kae Stahlnecker, ARNP

  • Family Nurse Practitioner
  • Walla Walla, WA
National Provider Identifier
1609808013
Registry record updated Jul 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP30007303 Issued in WA
Practice address
1125 S 2ND Ave
Ste B
Walla Walla, WA 99362-4118
Phone
(509) 525-2333
NPI assigned
Jul 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN00130093 WA
Family Nurse Practitioner 363LF0000X AP30007303 WA Primary

Addresses

Primary practice location

1125 S 2ND Ave
Ste B
Walla Walla, WA 99362-4118

Mailing address

PO Box 1663
Walla Walla, WA 99362-0031

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
I20061031000433 WA Practitioner - Nurse Practitioner 7315944576 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
73 of 100Reported as group
Quality
100
Improvement activities
40
Cost
10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN00130093WAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain West Derm - Blackhart PLLC CurrentSince Oct 1, 2020 Accepting new patients
Atomic Dermatology LLC CurrentSince May 1, 2024 Accepting new patients
Atomic2 Dermatology PLLC CurrentSince May 1, 2024 Accepting new patients
Mountain West Derm-Blackhart, PLLC CurrentSince Oct 1, 2020 Accepting new patients
Mountain West Derm - Blackhart PLLC Past Accepting new patients
David P Woolever MD Past Accepting new patients
Anesthesiology Consultants of Walla Walla PC Past Accepting new patients
Commonspirit Oregon Past Accepting new patients

Locations

9221 Sandifur Pkwy
Ste A
Pasco, WA 99301
Phone (509) 233-7546

5905 N Mayfair St
#200
Spokane, WA 99208
Phone 51293039091255

228 W Birch St
Walla Walla, WA 99362
Phone (509) 525-9404

105 S 3rd Ave
Walla Walla, WA 99362
Phone (509) 240-2554

1125 S 2nd Ave
#A
Walla Walla, WA 99362
Phone (509) 525-9404

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184544000000",
    "number": "1609808013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1663",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993620031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 S 2ND AVE",
            "address_2": "STE B",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993624118",
            "telephone_number": "509-525-2333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAHLNECKER",
        "first_name": "MARLA KAE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN00130093",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP30007303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walla Walla, WA

Sources for this page

Verify at the official NPI Registry.