South Correctional Entity

Primary specialty

Prison Health Clinic/CenterTaxonomy code 261QP2400X

Legal business name

SOUTH CORRECTIONAL ENTITY

Practice address

20817 17TH Ave S
Des Moines, WA 98198-7665

Phone

(206) 257-6200

NPI assigned

Feb 25, 2025

Last updated

Feb 25, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Devon Schrum

Title

Executive Director

Phone

(206) 257-6262

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lauren Donovan

  • Registered Nurse
  • Des Moines, WA
  • NPI 1174431936
  NPD (past)
• Michelle Anne Mijal, RN, BSN

  • Registered Nurse
  • Des Moines, WA
  • NPI 1659226207
  NPD (past)
• Arthur Maina Wangeci, LPN

  • Licensed Practical Nurse
  • Des Moines, WA
  • NPI 1104779842
  NPD (past)
• Jackson Mwangi Wanjohi, RN

  • Registered Nurse
  • Kirkland, WA
  • NPI 1336977107
  NPD (past)

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

{
    "created_epoch": "1740441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740441600000",
    "number": "1851198212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20817 17TH AVE S",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "981987665",
            "telephone_number": "206-257-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20817 17TH AVE S",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "981987665",
            "telephone_number": "206-257-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CORRECTIONAL ENTITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-25",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-19",
        "status": "A",
        "authorized_official_last_name": "SCHRUM",
        "authorized_official_first_name": "DEVON",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "206-257-6262"
    },
    "taxonomies": [
        {
            "code": "261QP2400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Prison Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Smita Patel Des Moines DMD PC
• Smita Patel, DMD PLLC (Smiles by Smita Orthodontics)
• Chelsea Marie Smith, LICSW
• Eun Jung Song, PHARM D
• Sound View Senior Care
• Debbie Anne Spurling, MSW
• Deborah St. Germain, COTA/L
• Stafford Healthcare, Seatac, LLC (Stafford Healthcare)
• Step Up ABA, LLC
• Stacy Stephenson, RN

• Prison Health Clinic/Center in Des Moines, WA
• Providers in Des Moines, WA by specialty
• Prison Health Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.