Individual provider Active NPI

Ma Isabel Abuhon Obligacion, NP

  • Family Nurse Practitioner
  • Maple Valley, WA
National Provider Identifier
1760017115
Registry record updated Mar 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
61041130 Issued in WA
Practice address
23745 225TH Way SE Ste 201
Maple Valley, WA 98038-5294
Phone
(800) 674-5871
Fax
(206) 694-2291
NPI assigned
Mar 5, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 61041130 WA Primary

Addresses

Primary practice location

23745 225TH Way SE Ste 201
Maple Valley, WA 98038-5294

Mailing address

23745 225TH Way SE Ste 201
Maple Valley, WA 98038-5294
Phone (800) 674-5871

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
I20200717000720 WA Practitioner - Nurse Practitioner 5991129363 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
PB Primary Care Clinic LLCGroup PAC ID 3274763628, 2 clinicians

Practice addresses (Care Compare)

34617 11TH PL S
Federal Way, WA 98003-8706
Phone (253) 874-8445

34617 11TH PL S
Suite 104
Federal Way, WA 98003-8705

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61041130WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
PB Primary Care Clinic LLC CurrentSince Mar 3, 2021 Accepting new patients

Locations

34617 11th Pl S
Ste 204
Federal Way, WA 98003
Phone (253) 874-8445

Interoperability endpoints

  • Direct secure messaging: ma.isabel.obligacion.1@33197.direct.athenahealth.com

Organizations & group practices 2

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": "1583366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583366400000",
    "number": "1760017115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23745 225TH WAY SE STE 201",
            "city": "MAPLE VALLEY",
            "state": "WA",
            "postal_code": "980385294",
            "telephone_number": "800-674-5871",
            "fax_number": "206-694-2291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23745 225TH WAY SE STE 201",
            "city": "MAPLE VALLEY",
            "state": "WA",
            "postal_code": "980385294",
            "telephone_number": "800-674-5871",
            "fax_number": "206-694-2291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBLIGACION",
        "first_name": "MA ISABEL",
        "middle_name": "ABUHON",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-05",
        "last_updated": "2020-03-05",
        "certification_date": "2020-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "61041130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Valley, WA

Sources for this page

Verify at the official NPI Registry.