Individual provider Active NPI

Lakew Adnew

  • Psychiatric/Mental Health Nurse Practitioner
  • Des Moines, WA
National Provider Identifier
1710389846
Registry record updated Apr 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP60480672 Issued in WA
Practice address
22634 10TH Ave S
Des Moines, WA 98198-6915
Phone
(206) 235-8112
Fax
(206) 653-7300
NPI assigned
Sep 19, 2014
Last updated
Apr 11, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP60480672 WA Primary

Addresses

Primary practice location

22634 10TH Ave S
Des Moines, WA 98198-6915

Mailing address

22634 10TH Ave S
Des Moines, WA 98198-6915
Phone (206) 235-8112

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20180710001624 WA Practitioner - Nurse Practitioner 5991051708 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Lutheran Community Services Northwest CurrentSince May 26, 2018 Accepting new patients
Sound View Senior Care CurrentSince Jun 23, 2019 Accepting new patients
Lutheran Community Services Northwest Current Accepting new patients

Locations

2500 Hewitt Ave
Ste 300
Everett, WA 98201
Phone (206) 694-5700

4040 S 188th St
Ste 300
Seatac, WA 98188
Phone (206) 816-3253

9725 3rd Ave NE
Ste 405
Seattle, WA 98115
Phone (206) 238-0946

210 W Sprague Ave
Spokane, WA 99201
Phone (509) 747-8224

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1411084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554940800000",
    "number": "1710389846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22634 10TH AVE S",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "981986915",
            "telephone_number": "206-235-8112",
            "fax_number": "206-653-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22634 10TH AVE S",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "981986915",
            "telephone_number": "206-235-8112",
            "fax_number": "206-653-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADNEW",
        "first_name": "LAKEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-19",
        "last_updated": "2019-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP60480672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, WA

Sources for this page

Verify at the official NPI Registry.