Kenneth Britt Dyer, DNP, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP60863385 Issued in WA

Practice address

21907 64TH Ave W Ste 200
Mountlake Terrace, WA 98043-6200

Phone

(425) 640-7009

NPI assigned

Jun 27, 2018

Last updated

Jun 19, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Eleanor Health Professional Wa, PLLC

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Everett, WA
  • NPI 1043827132
  Medicare reassignment NPD
• Mindful Therapy Group PC

  dba Mindful Therapy Group

  • Clinical Social Worker
  • Mountlake Terrace, WA
  • NPI 1316238678

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Providence Health & Services-Wa

  • Mammography Clinic/Center
  • Everett, WA
  • NPI 1336390442
  Medicare reassignment NPD
• Shifa Health PLLC

  • Cognitive & Behavioral Psychologist
  • Mount Vernon, WA
  • NPI 1356415327
  Medicare reassignment NPD
• Providence Health & Services-Washington

  dba Providence Surgery Center, Pacific Campus

  • Ambulatory Surgical Clinic/Center
  • Everett, WA
  • NPI 1588294854
  NPD

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

{
    "created_epoch": "1530057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1790270296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10333 19TH AVE, SE, S #109",
            "address_2": "S #109",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "98208",
            "telephone_number": "425-742-4600",
            "fax_number": "425-225-6859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21907 64TH AVE W STE 200",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980436200",
            "telephone_number": "425-640-7009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYER",
        "first_name": "KENNETH",
        "middle_name": "BRITT",
        "name_prefix": "Dr.",
        "credential": "DNP, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-27",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP60863385",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP60863385",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60076562",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamara Anne Dow, B.S., NCACI
• James R Downey, MD
• Jerrald B Dreessen, DC CCSP
• Darrel Duane Dreke, D.D.S.
• Michelle Dwyer, R.N.
• Julianne M Dynneson
• Jeromy A Easter
• Erin Rebecca Eaton, OT
• Brianna Ba-Lin Edin
• Edmonds Endocrinology

• Psychiatric/Mental Health Nurse Practitioner in Mountlake Terrace, WA
• Providers in Mountlake Terrace, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.