Petrina E Gavrilis, RN, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP60410653 Issued in WA

Practice address

1125 SE Washington St.
Pullman, WA 99164

Phone

(509) 335-3575

Fax

(509) 335-6223

NPI assigned

Nov 15, 2006

Last updated

Jan 16, 2019By the provider in NPPES

Sex

Female

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 3

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

Practice roles

Locations

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.

• Littlerock Family Medicine, P.S.

  • Family Medicine Physician
  • Tumwater, WA
  • NPI 1689994527
  NPD
• Harkness Medical Group, PLLC

  • Family Medicine Physician
  • Olympia, WA
  • NPI 1215518113
  NPD (past)
• Washington State University

  dba Cougar Health Services

  • Family Medicine Physician
  • Pullman, WA
  • NPI 1285713776
  NPD (past)

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547596800000",
    "number": "1700958493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 642302",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991642302",
            "telephone_number": "509-335-3575",
            "fax_number": "509-335-6223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 SE WASHINGTON ST.",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "99164",
            "telephone_number": "509-335-3575",
            "fax_number": "509-335-6223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAVRILIS",
        "first_name": "PETRINA",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "RN, ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2019-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60410653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700958493",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WVH PTAN",
            "identifier": "G8969935",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WVH PTAN",
            "identifier": "G8969934",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clara E Garcia, MD
• Eddie Raul Garcia, ATC
• Hanna E. Gash, SW AAL
• Keith M Gautreaux, M.D.
• Justine A Gavagan, MD
• Tina M Gearhart, CNM
• Katherine Geiger, PHD
• Cathy George, L.M.P.
• Andrew Gepford, MA, ATC/L
• William Thomas Gibson, NP, PHD

• Family Nurse Practitioner in Pullman, WA
• Providers in Pullman, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.