Individual provider Active NPI

Zoe R Edris, RN

  • Registered Nurse
  • Lynnwood, WA
National Provider Identifier
1841067477
Registry record updated Dec 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN.00174962 Issued in WA
Practice address
3411 Serene Way
Lynnwood, WA 98087-5201
Phone
(816) 392-1216
NPI assigned
Dec 4, 2023
Last updated
Dec 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN.00174962 WA Primary

Addresses

Primary practice location

3411 Serene Way
Lynnwood, WA 98087-5201

Mailing address

3411 Serene Way
Lynnwood, WA 98087-5201
Phone (816) 392-1216

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN.00174962WAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1701648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1841067477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3411 SERENE WAY",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980875201",
            "telephone_number": "816-392-1216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3411 SERENE WAY",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980875201",
            "telephone_number": "816-392-1216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDRIS",
        "first_name": "ZOE",
        "middle_name": "R",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-04",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN.00174962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.