Individual provider Active NPI

Nelly O. Santiago

  • Registered Nurse
  • Bellingham, WA
National Provider Identifier
1770004632
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
60552650 Issued in WA
Practice address
609 Northshore Dr
Bellingham, WA 98226-4414
Phone
(360) 398-5304
NPI assigned
Jun 30, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 60552650 WA Primary

Addresses

Primary practice location

609 Northshore Dr
Bellingham, WA 98226-4414

Mailing address

609 Northshore Dr
Bellingham, WA 98226-4414
Phone (360) 398-5304

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
60552650WAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Whatcom Residential & Treatment Center CurrentSince Jul 24, 2022 Accepting new patients

Locations

609 Northshore Dr
Bellingham, WA 98226
Phone (360) 676-6000

Organizations & group practices 1

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": "1498780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1770004632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 NORTHSHORE DR",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982264414",
            "telephone_number": "360-398-5304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 NORTHSHORE DR",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982264414",
            "telephone_number": "360-398-5304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "NELLY",
        "middle_name": "O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-30",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "60552650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.