Organization Active NPI

Nurse Practitioners Northwest, PLLC

  • Gerontology Nurse Practitioner
  • Tacoma, WA
National Provider Identifier
1790014223
Registry record updated Jul 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
AP30001790 Issued in WA
Legal business name
NURSE PRACTITIONERS NORTHWEST, PLLC
Practice address
5115 Beverly Avenue NE
Tacoma, WA 98422-1823
Phone
(253) 797-6239
Fax
(253) 927-2119
NPI assigned
Dec 11, 2009
Last updated
Jul 1, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2010

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

Authorized official

Name
Margaret Elvira Sackmann, ARNPNPI 1801814579
Title
Owner
Phone
(253) 797-6239

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X AP30001790 WA Primary

Addresses

Primary practice location

5115 Beverly Avenue NE
Tacoma, WA 98422-1823

Mailing address

PO Box 23838
Federal Way, WA 98093-0838
Phone (253) 797-6239

Other identifiers 1

IdentifierTypeStateIssuer
2005946MedicaidWA

National Provider Directory

National Provider Directory

Locations

630 S Pearl St
Tacoma, WA 98465
Phone (253) 564-7111

3625 Drexler Dr W
University Place, WA 98466
Phone (253) 460-3330

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1260489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277942400000",
    "number": "1790014223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23838",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980930838",
            "telephone_number": "253-797-6239",
            "fax_number": "253-927-2119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5115 BEVERLY AVENUE NE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984221823",
            "telephone_number": "253-797-6239",
            "fax_number": "253-927-2119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NURSE PRACTITIONERS NORTHWEST, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-11",
        "last_updated": "2010-07-01",
        "status": "A",
        "authorized_official_last_name": "SACKMANN",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_middle_name": "ELVIRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-797-6239",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WA",
            "license": "AP30001790",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2005946",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2010; 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.