NPIMap

Individual provider Active NPI

Debra S Hall, ARNP

  • Family Nurse Practitioner
  • Olympia, WA
National Provider Identifier
1619289485
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP60163671 Issued in WA
Practice address
200 Lilly Rd NE Ste C
Olympia, WA 98506-5080
Phone
(360) 918-8336
Fax
(360) 972-2152
NPI assigned
Jul 9, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AP60163671 WA
Family Nurse Practitioner 363LF0000X AP60163671 WA Primary

Addresses

Primary practice location

200 Lilly Rd NE Ste C
Olympia, WA 98506-5080

Mailing address

200 Lilly Rd NE
Olympia, WA 98506-5427
Phone (360) 918-8336

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
I20101129000473 WA Practitioner - Nurse Practitioner 3779779038 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Resources IIGroup PAC ID 3678842788, 3 clinicians

Practice addresses (Care Compare)

200 Lilly Rd NE
Suite C
Olympia, WA 98506-5080
Phone (360) 918-8336

2708 Westmoor CT SW
Olympia, WA 98502-5754
Phone (360) 943-8810

3285 Ferguson St SW
Tumwater, WA 98512-6192
Phone (510) 337-7950

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP60163671WAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Telecare Mental Health Services of Washington Inc CurrentSince Jul 4, 2023 Accepting new patients
Telecare Mental Health Services of Washington, Inc Current Accepting new patients
Telecare Mental Health Services of Washington, Inc CurrentSince Jul 4, 2023 Accepting new patients
Northwest Resources II Family Past Accepting new patients

Locations

1080 Marina Village Pkwy
Ste 100
Alameda, CA 94501
Phone (510) 306-5660

322 S Birch St
McCleary, WA 98557
Phone (360) 205-4750

9601 Steilacoom Blvd SW
Bldg 27
Tacoma, WA 98498
Phone (253) 589-5334

3285 Ferguson St SW
Tumwater, WA 98512
Phone (360) 252-2989

Organizations & group practices 5

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": "1278633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1619289485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 LILLY RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065427",
            "telephone_number": "360-918-8336",
            "fax_number": "360-861-6018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 LILLY RD NE STE C",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065080",
            "telephone_number": "360-918-8336",
            "fax_number": "360-972-2152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "DEBRA",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-09",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WA",
            "license": "AP60163671",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60163671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.