Todd R Ouellette, ARNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP30002202 Issued in WA

Practice address

2101 Little Mountain LN
Mount Vernon, WA 98274-8752

Phone

(360) 428-2622

Fax

(360) 428-3941

NPI assigned

Mar 27, 2007

Last updated

Sep 8, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315440000000",
    "number": "1679691505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 LITTLE MOUNTAIN LN",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982748752",
            "telephone_number": "360-428-2622",
            "fax_number": "360-428-3941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 LITTLE MOUNTAIN LN",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982748752",
            "telephone_number": "360-428-2622",
            "fax_number": "360-428-3941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OUELLETTE",
        "first_name": "TODD",
        "middle_name": "R",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2011-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP30002202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9620253",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Mount Vernon, WA
• Providers in Mount Vernon, WA by specialty
• Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2011; 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.