Active NPI
Angela Lynn Mirador, RN
- Registered Nurse
- Silverdale, WA
National Provider Identifier
1669289476
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 61173998
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 61173998 | WA | MD | Registered 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.