Individual provider Active NPI

Angela Lynn Mirador, RN

  • Registered Nurse
  • Silverdale, WA
National Provider Identifier
1669289476
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
61173998 Issued in WA
Practice address
10049 Kitsap Mall Blvd NW Ste 201
Silverdale, WA 98383-8901
Phone
(360) 373-6966
NPI assigned
Dec 16, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X 61173998 WA
Registered Nurse 163W00000X 61173998 WA Primary

Addresses

Primary practice location

10049 Kitsap Mall Blvd NW Ste 201
Silverdale, WA 98383-8901

Mailing address

7012 Osprey Cir
Bremerton, WA 98312-8852
Phone (360) 509-1547

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
61173998WAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1734307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1669289476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7012 OSPREY CIR",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983128852",
            "telephone_number": "360-509-1547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10049 KITSAP MALL BLVD NW STE 201",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983838901",
            "telephone_number": "360-373-6966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRADOR",
        "first_name": "ANGELA",
        "middle_name": "LYNN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-16",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "WA",
            "license": "61173998",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "61173998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silverdale, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.