Individual provider Active NPI

Salome Munyori

  • Psychiatric/Mental Health Nurse Practitioner
  • Spokane, WA
National Provider Identifier
1659786143
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP61098523 Issued in WA
Practice address
104 W 5TH Ave
Spokane, WA 99204-4820
Phone
(509) 992-1888
NPI assigned
Jun 24, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP61098523 WA
Gerontology Nurse Practitioner 363LG0600X RN183874 GA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP61098523 WA Primary
Adult Health Nurse Practitioner 363LA2200X RN183874 GA
Adult Health Nurse Practitioner 363LA2200X AP61098523 WA

Addresses

Primary practice location

104 W 5TH Ave
Spokane, WA 99204-4820

Mailing address

104 W 5TH Ave
Spokane, WA 99204-4820
Phone (509) 992-1888

Other practice location 1

62 Sweet Birch Ln
Dallas, GA 30132-9749
Phone (404) 483-8731

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
I20210217002731 WA Practitioner - Nurse Practitioner 5496055410 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spokane Behavioral Health LLCGroup PAC ID 2961757489, 24 clinicians
Cedarcrest Behavioral Medicine LLCGroup PAC ID 1456871466, 2 clinicians

Practice addresses (Care Compare)

104 W 5TH Ave
Spokane, WA 99204-4820
Phone (623) 670-0840

12623 E Sprague Ave
Suite 6
Spokane Valley, WA 99216-0764
Phone (509) 505-4035

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP61098523WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vytaliz Medical CurrentSince Jul 10, 2026 Accepting new patients
Cedarcrest Behavioral Medicine LLC Psychiatric/Mental Health CurrentSince Jan 15, 2025 Accepting new patients
Spokane Behavioral Health LLC CurrentSince Dec 10, 2020 Accepting new patients

Locations

104 W 5th Ave
Spokane, WA 99204
Phone (509) 992-1888

12623 E Sprague Ave
Ste 6
Spokane Valley, WA 99216
Phone (509) 505-4035

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1403568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1659786143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 W 5TH AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992044820",
            "telephone_number": "509-992-1888",
            "fax_number": "509-293-6508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 W 5TH AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992044820",
            "telephone_number": "509-992-1888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "62 Sweet Birch Ln",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "GA",
            "postal_code": "301329749",
            "country_code": "US",
            "telephone_number": "404-483-8731",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUNYORI",
        "first_name": "SALOME",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-24",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61098523",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "RN183874",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61098523",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN183874",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WA",
            "license": "AP61098523",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.