Active NPI
Brenda Lee Anita Marie Stavish, BSN MSN ARNP
- Women's Health Nurse Practitioner
- Burien, WA
National Provider Identifier
1669571394
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Women's Health Nurse Practitioner
- License
- AP30007442
- Practice address
- 16233 Sylvester Rd SW
Suite G40
Burien, WA 98166-3045 - Phone
- (206) 244-6625
- Fax
- (206) 244-6726
- NPI assigned
- Sep 21, 2006
- Last updated
- Mar 10, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | AP30007442 | WA | Primary |
Addresses
Primary practice location
16233 Sylvester Rd SW
Suite G40
Burien, WA 98166-3045
Mailing address
2916 N 32ND St
Tacoma, WA 98407-6436
Phone (206) 890-8074
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0219212 | Other | WA | L&I |
| 1669571394 | Medicaid | WA |
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)
- Enrolled
- Credentials
- Bachelor on Science - Nursing, Master of Science - Nursing, Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Issaquah Obstetrics and Gynecology PLLC | Past | Accepting new patients | |
| Highline Medical Group Inc | Women's Health | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Obstetrics & Gynecology Physician
- Issaquah, WA
- NPI 1073581807
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583798400000",
"number": "1669571394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2916 N 32ND ST",
"city": "TACOMA",
"state": "WA",
"postal_code": "984076436",
"telephone_number": "206-890-8074",
"fax_number": "206-244-6726"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16233 SYLVESTER RD SW",
"address_2": "SUITE G40",
"city": "BURIEN",
"state": "WA",
"postal_code": "981663045",
"telephone_number": "206-244-6625",
"fax_number": "206-244-6726"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAVISH",
"first_name": "BRENDA LEE",
"middle_name": "ANITA MARIE",
"credential": "BSN MSN ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-21",
"last_updated": "2020-03-10",
"certification_date": "2020-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "WA",
"license": "AP30007442",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I",
"identifier": "0219212",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1669571394",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Burien, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.