Individual provider Active NPI

Maria Jelyn B Engelhardt-Parales, NP-C

  • Primary Care Nurse Practitioner
  • Tacoma, WA
National Provider Identifier
1750046157
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
61165549 Issued in WA
Practice address
3716 Pacific Ave Ste D
Tacoma, WA 98418-7836
Phone
(253) 474-7719
NPI assigned
Nov 2, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 60244982 WA
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X 2021085251 WA
Primary Care Nurse Practitioner 363LP2300X 61165549 WA Primary

Addresses

Primary practice location

3716 Pacific Ave Ste D
Tacoma, WA 98418-7836

Mailing address

3716 Pacific Ave Ste D
Tacoma, WA 98418-7836
Phone (253) 474-7719

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
I20220318002372 WA Practitioner - Nurse Practitioner 3375938855 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4936 40TH St NE
Tacoma, WA 98422-3028
Phone (253) 921-8109

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
60244982WAMDRegistered Nurse
2021085251WAMDAdult Psychiatric/Mental Health Registered Nurse
61165549WAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Key Bridge Medical Clinic LLC CurrentSince Feb 15, 2022 Accepting new patients
J E Parales Medical PLLC Primary Care CurrentSince Dec 1, 2021 Accepting new patients
Southwest Portland Medical Clinic Inc PastSince Jan 1, 2024 Accepting new patients

Locations

11318 Bridgeport Way SW
Ste A
Lakewood, WA 98499
Phone (253) 380-8905

3716 Pacific Ave
Ste D
Tacoma, WA 98418
Phone (253) 474-7719

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1635811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1750046157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3716 PACIFIC AVE STE D",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984187836",
            "telephone_number": "253-474-7719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3716 PACIFIC AVE STE D",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984187836",
            "telephone_number": "253-474-7719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGELHARDT-PARALES",
        "first_name": "MARIA JELYN",
        "middle_name": "B",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-02",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "60244982",
            "primary": false
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "WA",
            "license": "2021085251",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "WA",
            "license": "61165549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.