Pauline Mumbua Minnis

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN60350587 Issued in WA

Practice address

11410 NE 122ND Way
Kirkland, WA 98034-6945

Phone

(425) 650-4005

NPI assigned

Sep 23, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Connectionswa, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Kirkland, WA
  • NPI 1558042234
  NPD (past)

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

{
    "created_epoch": "1727049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1689491656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17814 110TH PL SE",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980556560",
            "telephone_number": "206-458-4069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11410 NE 122ND WAY",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980346945",
            "telephone_number": "425-650-4005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINNIS",
        "first_name": "PAULINE",
        "middle_name": "MUMBUA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-23",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60350587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samuel Miller
• Judith Renae Milligan
• Anna Millikan
• Kurt William Mills, O.D.
• Lacy Milonas, MA, MHP, LMHCA
• Dennis Stephen Minno, MA
• Garland Minor
• David George Mioduski, L. AC.
• Cora Belle Miranda
• Michelle Ariadna Miranda

• Registered Nurse in Kirkland, WA
• Providers in Kirkland, WA by specialty
• Registered Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.

Verify at the official NPI Registry.