Active NPI
Autumn Annalise Dennistoun, RN
- Student in an Organized Health Care Education/Training Program
- Seattle, WA
National Provider Identifier
1780305136
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 1705 NE Pacific St
Seattle, WA 98195-0009 - Phone
- (206) 543-8736
- NPI assigned
- Sep 5, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN60912993 | WA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
1705 NE Pacific St
Seattle, WA 98195-0009
Mailing address
2325 Crosby Dr
Mount Vernon, WA 98274-9011
Phone (360) 708-1835
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN60912993 | WA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1662336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662336000000",
"number": "1780305136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2325 CROSBY DR",
"city": "MOUNT VERNON",
"state": "WA",
"postal_code": "982749011",
"telephone_number": "360-708-1835"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1705 NE PACIFIC ST",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981950009",
"telephone_number": "206-543-8736"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DENNISTOUN",
"first_name": "AUTUMN",
"middle_name": "ANNALISE",
"name_prefix": "Miss",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-09-05",
"last_updated": "2022-09-05",
"certification_date": "2022-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WA",
"license": "RN60912993",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.