Active NPI
Oluwademilade Elizabeth Fajemisin
- Psychiatric/Mental Health Nurse Practitioner
- Seattle, WA
National Provider Identifier
1831024769
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- R249901
- Practice address
- 1040 S Henderson St
Seattle, WA 98108-4720 - Phone
- (206) 763-5277
- NPI assigned
- Jun 13, 2026
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | R249901 | MD | Primary |
Addresses
Primary practice location
1040 S Henderson St
Seattle, WA 98108-4720
Mailing address
5328 Crittenden St
Hyattsville, MD 20781-2633
Phone (240) 815-9555
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1781308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781308800000",
"number": "1831024769",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5328 CRITTENDEN ST",
"city": "HYATTSVILLE",
"state": "MD",
"postal_code": "207812633",
"telephone_number": "240-815-9555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1040 S HENDERSON ST",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981084720",
"telephone_number": "206-763-5277"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAJEMISIN",
"first_name": "OLUWADEMILADE",
"middle_name": "ELIZABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-06-13",
"last_updated": "2026-06-13",
"certification_date": "2026-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "MD",
"license": "R249901",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.