Tina Marie Anderson, ARNP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

AP61366551 Issued in WA

Practice address

707 S Grady Way Ste 400
Renton, WA 98057-3246

Phone

(509) 975-9397

Fax

(866) 299-8687

NPI assigned

Feb 7, 2023

Last updated

Sep 11, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1675728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1659077048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 S GRADY WAY STE 400",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980573246",
            "telephone_number": "509-975-9397",
            "fax_number": "866-299-8687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 S GRADY WAY STE 400",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980573246",
            "telephone_number": "509-975-9397",
            "fax_number": "866-299-8687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "TINA",
        "middle_name": "MARIE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-07",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WA",
            "license": "AP61366551",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WA",
            "license": "AP61366551",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "WA",
            "license": "AP61366551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ian Anderson, ATC
• Jennifer Anderson, PHARMD
• Katelyn Anderson, RN, BSN
• Kristi Welch Anderson, P.T.
• Michael R Anderson, MD
• William Alphaunce Anderson III, M.D.
• Andrew Jordan Andrada, PT
• Lhorrana P Andrade Dasilva, DPT
• Damaris Andrade, PMHNP
• Amber Andrews, RD

• Primary Care Nurse Practitioner in Renton, WA
• Providers in Renton, WA by specialty
• Primary Care Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; 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.