Active NPI
Patricia Lynn Dykstra, ARNP
- Family Nurse Practitioner
- Medical Lake, WA
National Provider Identifier
1821081308
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- AP30007404
- Practice address
- 850 Maple Street
Medical Lake, WA 99022-0800 - Phone
- (509) 565-4000
- Fax
- (509) 565-4705
- NPI assigned
- Aug 30, 2005
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | AP30007404 | WA | Primary |
| Ambulatory Women's Health Care Registered Nurse | 163WW0101X | RN00164832 | WA |
Addresses
Primary practice location
850 Maple Street
Medical Lake, WA 99022-0800
Mailing address
P.O. Box 800
850 Maple Street
Medical Lake, WA 99022-0800
Phone (509) 565-4000
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Department of Social | Past | Accepting new patients | |
| Eastern State Hospital Pharmacy | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Long Term Care Pharmacy
- Medical Lake, WA
- NPI 1679651970
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444262400000",
"number": "1821081308",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 800",
"address_2": "850 MAPLE STREET",
"city": "MEDICAL LAKE",
"state": "WA",
"postal_code": "990220800",
"telephone_number": "509-565-4000",
"fax_number": "509-565-4705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "850 MAPLE STREET",
"city": "MEDICAL LAKE",
"state": "WA",
"postal_code": "990220800",
"telephone_number": "509-565-4000",
"fax_number": "509-565-4705"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DYKSTRA",
"first_name": "PATRICIA",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-30",
"last_updated": "2015-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "WA",
"license": "AP30007404",
"primary": true
},
{
"code": "163WW0101X",
"taxonomy_group": "",
"desc": "Registered Nurse, Women's Health Care, Ambulatory",
"state": "WA",
"license": "RN00164832",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medical Lake, WA
- Cassandra J Dubbels
- Cindy Lynn Dudley, ARNP
- Philip Gordon Dunbar, RPH PHD
- Dutton Veterinary Medicine PLLC (Medical Lake Veterinary Clinic)
- Amber Nichole Dvorak, L.M.P.
- Eastern State Hospital Pharmacy
- Educational Support Services (Medical Lake School District)
- David W. Elkins Jr., PHD
- Aubry Elizabeth Espinosa, RCIS
- Essential Psychiatry, PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.