Mary D Moller, DNP, APRN, PMHCNS-BC

Primary specialty

Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X

License

AP30003075 Issued in WA

Practice address

5929 Westgate Blvd
Tacoma, WA 98406-2567

Phone

(253) 200-0415

Fax

(253) 625-7912

NPI assigned

Jul 20, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Nurse Practitioner

Education

Other, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rainier Internal Medicine LLCGroup PAC ID 7911049242, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmoller218124@direct.multicare.org

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.

• Rainier Internal Medicine LLC

  • Primary Care Clinic/Center
  • Lakewood, WA
  • NPI 1972735157
  Medicare reassignment Care Compare group NPD
• Moller Enterprises Inc

  • Clinic/Center
  • Nine Mile Falls, WA
  • NPI 1447250410
  NPD (past) Authorized official
• Rainier Internal Medicine LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Puyallup, WA
  • NPI 1356716351
  NPD (past)

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1770582884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MARY D. MOLLER",
            "address_2": "14702 41ST AVE CT NW",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983322471",
            "telephone_number": "203-747-5667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5929 WESTGATE BLVD",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984062567",
            "telephone_number": "253-200-0415",
            "fax_number": "253-625-7912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLLER",
        "first_name": "MARY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DNP, APRN, PMHCNS-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-20",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "WA",
            "license": "AP30003075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN LICENSE",
            "identifier": "004003",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARNP LIC #",
            "identifier": "AP30003075",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Talalelei Tofa Molimala
• Claudia B Molina Clemen
• Loren Petrozella Molina, MD
• Linet Molinero, MSW
• Randee Moll Petersen, MA, OTR/L
• Beverley Catherine Moloney
• Kingson I Momah, MD
• Colleen Monaghan
• Isabel Monaghan
• Angela Maria Moncada, LCSW

• Adult Psychiatric/Mental Health Clinical Nurse Specialist in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Adult Psychiatric/Mental Health Clinical Nurse Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.