Individual provider Active NPI

Mary Elizabeth Macejunas

  • Psychiatric/Mental Health Nurse Practitioner
  • Tacoma, WA
National Provider Identifier
1780560417
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP70016174 Issued in WA
Practice address
603 S J St Apt 317
Tacoma, WA 98405-4168
Phone
(253) 651-1486
NPI assigned
Aug 15, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2025

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 AP70016174 WA Primary

Addresses

Primary practice location

603 S J St Apt 317
Tacoma, WA 98405-4168

Mailing address

603 S J St Apt 317
Tacoma, WA 98405-4168
Phone (253) 651-1486

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
I20251231003424 WA Practitioner - Nurse Practitioner 2668968322 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

315 MLK Jr Way
Tacoma, WA 98405-4159

PO Box
Suite 5299
Tacoma, WA 98415

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP70016174WAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Dec 3, 2025 Accepting new patients
Multicare Health System CurrentSince Dec 3, 2025 Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

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.

NPI Registry JSON

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

{
    "created_epoch": "1755216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755216000000",
    "number": "1780560417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 S J ST APT 317",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054168",
            "telephone_number": "253-651-1486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 S J ST APT 317",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054168",
            "telephone_number": "253-651-1486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACEJUNAS",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-15",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP70016174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.