Individual provider Active NPI

Carrie Ann Matyac, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Olympia, WA
National Provider Identifier
1669439451
Registry record updated Sep 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP30006999 Issued in WA
Practice address
413 Lilly Rd NE
Olympia, WA 98506-5133
Phone
(360) 493-7060
NPI assigned
Apr 27, 2006
Last updated
Sep 17, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP30006999 WA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP30006999 WA Primary
Family Nurse Practitioner 363LF0000X AP30006999 WA

Addresses

Primary practice location

413 Lilly Rd NE
Olympia, WA 98506-5133

Mailing address

413 Lilly Rd NE
Olympia, WA 98506-5133

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
I20051014000195 WA Practitioner - Nurse Practitioner 6507881984 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jamestown S'Klallam Tribe CurrentSince Jun 15, 2021 Accepting new patients
Jamestown S'Klallam Tribe CurrentSince Jun 15, 2021 Accepting new patients
Capital Clubhouse Past Accepting new patients
Tenino Family Practice PLLC Past Accepting new patients
Leyton Endicott Jump Past Accepting new patients

Locations

526 S 9th Ave
Sequim, WA 98382
Phone (360) 681-7755

808 N 5th Ave
Sequim, WA 98382
Phone (360) 582-4840

Interoperability endpoints

  • Direct secure messaging: cmatyac545532@wm.providencedirect.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789603200000",
    "number": "1669439451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 LILLY RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 LILLY RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065133",
            "telephone_number": "360-493-7060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATYAC",
        "first_name": "CARRIE",
        "middle_name": "ANN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-27",
        "last_updated": "2026-09-17",
        "certification_date": "2026-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP30006999",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP30006999",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP30006999",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.