Active NPI
Reidun E Pederson, RN
- Registered Nurse
- La Conner, WA
National Provider Identifier
1669805180
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN65356
- Practice address
- 403 State St.
La Conner, WA 98257 - Phone
- (360) 739-5656
- NPI assigned
- Aug 20, 2013
- Last updated
- Aug 20, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN65356 | WA | Primary |
Addresses
Primary practice location
403 State St.
La Conner, WA 98257
Mailing address
PO Box 444
La Conner, WA 98257
Phone (360) 424-8404
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 |
|---|---|---|---|
| RN65356 | WA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1376956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1376956800000",
"number": "1669805180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 444",
"city": "LA CONNER",
"state": "WA",
"postal_code": "98257",
"telephone_number": "360-424-8404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "403 STATE ST.",
"city": "LA CONNER",
"state": "WA",
"postal_code": "98257",
"telephone_number": "360-739-5656"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEDERSON",
"first_name": "REIDUN",
"middle_name": "E",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-08-20",
"last_updated": "2013-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WA",
"license": "RN65356",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Conner, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.