Individual provider Active NPI

Sarah Manfred, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Spokane, WA
National Provider Identifier
1790344141
Registry record updated Nov 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP60974943 Issued in WA
Practice address
1611 W Indiana Ave
Spokane, WA 99205-4221
Phone
(509) 202-7514
Fax
(509) 568-3037
NPI assigned
Jun 10, 2019
Last updated
Nov 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2023

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 AP60974943 WA Primary

Addresses

Primary practice location

1611 W Indiana Ave
Spokane, WA 99205-4221

Mailing address

1611 W Indiana Ave
Spokane, WA 99205-4221
Phone (509) 202-7514

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)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kodiak Healthcare Psychiatric/Mental Health Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: smanfred219858@wm.providencedirect.org

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1560124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700611200000",
    "number": "1790344141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 W INDIANA AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992054221",
            "telephone_number": "509-202-7514",
            "fax_number": "509-568-3037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 W INDIANA AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992054221",
            "telephone_number": "509-202-7514",
            "fax_number": "509-568-3037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANFRED",
        "first_name": "SARAH",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-10",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP60974943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2023; 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.