Miguel Angel De la Mora, DNP, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP61485710 Issued in WA

Practice address

1030 N Center Pkwy Ste 113
Kennewick, WA 99336-7160

Phone

(509) 910-4559

Fax

(509) 447-7455

NPI assigned

Sep 7, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Modern Psychiatry

  • Psychiatric/Mental Health Nurse Practitioner
  • Kennewick, WA
  • NPI 1720972961
  NPD Authorized official
• Grant County Public Hospital District 1

  • Rural Health Clinic/Center
  • Moses Lake, WA
  • NPI 1619086766
  NPD (past)

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

{
    "created_epoch": "1694044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782864000000",
    "number": "1821874462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 N CENTER PKWY STE 113",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993367160",
            "telephone_number": "509-910-4559",
            "fax_number": "509-447-7455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 N CENTER PKWY STE 113",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993367160",
            "telephone_number": "509-910-4559",
            "fax_number": "509-447-7455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "650 NE Holladay St Ste 1675",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972322045",
            "country_code": "US",
            "telephone_number": "503-832-5105",
            "fax_number": "509-447-7455",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1220 Main St Ste 400",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986602963",
            "country_code": "US",
            "telephone_number": "360-977-7605",
            "fax_number": "509-447-7455",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11900 NE 1st St Ste 3049",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "WA",
            "postal_code": "980053046",
            "country_code": "US",
            "telephone_number": "425-600-5227",
            "fax_number": "509-447-7455",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE LA MORA",
        "first_name": "MIGUEL",
        "middle_name": "ANGEL",
        "name_prefix": "Dr.",
        "credential": "DNP, PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-07",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61485710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mdelamora2769266@wm.providencedirect.org",
            "affiliation": "N",
            "endpointDescription": "EPIC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1550 S Pioneer Way Ste 165",
            "city": "Moses Lake",
            "state": "WA",
            "country_code": "US",
            "postal_code": "988374637",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Chad Vernon Dawson, DDS
• Day-to-Day Home Care
• Kelin Day, DC
• Allison Ursala Dayton, LMP
• Sydney T. De Cejka, PA
• Anneliese Debeaumont
• Deborah L Smith, Ed.M./LMHC
• Dree Deckert, RN
• Kendra Deffenbaugh
• Marcia Leigh Deffenbaugh, RPH

• Psychiatric/Mental Health Nurse Practitioner in Kennewick, WA
• Providers in Kennewick, 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 Jul 1, 2026; 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.