Individual provider Active NPI

Lisa Mitchell, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Everett, WA
National Provider Identifier
1760049449
Registry record updated Jun 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP60964715 Issued in WA
Practice address
12800 Bothell Everett Hwy Ste 220
Everett, WA 98208-6642
Phone
(425) 316-5005
NPI assigned
May 28, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2021

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 AP60964715 WA Primary

Addresses

Primary practice location

12800 Bothell Everett Hwy Ste 220
Everett, WA 98208-6642

Mailing address

12800 Bothell Everett Hwy Ste 220
Everett, WA 98208-6642
Phone (425) 316-5005

Other practice location 1

19200 N Kelsey St
Monroe, WA 98272-1431
Phone (425) 316-5062

Other practice location 2

1700 13th St
Everett, WA 98201-1689
Phone (425) 261-2000

Other identifiers 1

IdentifierTypeStateIssuer
1124270715OtherGROUP NUMBER

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address lmitchell612237@wm.providencedirect.org Direct
Direct Messaging Address lmitchell612237@wm.providencedirect.org Direct
Direct Messaging Address lmitchell612237@wm.providencedirect.org Direct

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
I20190808003969 WA Practitioner - Nurse Practitioner 5991032294 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Association of University PhysiciansGroup PAC ID 0446162697, 3,484 clinicians

Practice addresses (Care Compare)

325 9TH Ave
Seattle, WA 98104-2420
Phone (206) 731-3000

Hospital & facility affiliations

  • Harborview Medical Center Hospital, Seattle, WA, CCN 500064

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP60964715WAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Association of University Physicians CurrentSince May 1, 2020 Accepting new patients
Providence Health & Services - Washington CurrentSince Aug 1, 2019 Accepting new patients
Providence Health & Services- Washington CurrentSince Aug 1, 2019 Accepting new patients

Locations

1321 Colby Ave
Ofc
Everett, WA 98201
Phone (425) 261-4076

12800 Bothell Everett Hwy
Ste 220
Everett, WA 98208
Phone (425) 239-8781

1700 13th St
Everett, WA 98201
Phone (425) 252-0895

19200 N Kelsey St
Monroe, WA 98272
Phone (360) 794-5555

4112 Harbour Pointe Blvd SW
Ste 100
Mukilteo, WA 98275
Phone (425) 347-6330

1959 NE Pacific St
Seattle, WA 98195
Phone (206) 598-4333

325 9th Ave
Seattle, WA 98104
Phone (206) 731-3000

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1559001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623974400000",
    "number": "1760049449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12800 BOTHELL EVERETT HWY STE 220",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982086642",
            "telephone_number": "425-316-5005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12800 BOTHELL EVERETT HWY STE 220",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982086642",
            "telephone_number": "425-316-5005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19200 N Kelsey St",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "WA",
            "postal_code": "982721431",
            "country_code": "US",
            "telephone_number": "425-316-5062",
            "fax_number": "425-261-4211",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1700 13th St",
            "address_purpose": "LOCATION",
            "city": "Everett",
            "state": "WA",
            "postal_code": "982011689",
            "country_code": "US",
            "telephone_number": "425-261-2000",
            "fax_number": "425-261-4211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "LISA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-28",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP60964715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NUMBER",
            "identifier": "1124270715",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lmitchell612237@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "12800 Bothell Everett Hwy Ste 220",
            "city": "Everett",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982086642",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lmitchell612237@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1700 13th St",
            "city": "Everett",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982011689",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lmitchell612237@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "19200 N Kelsey St",
            "city": "Monroe",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982721431",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.