Active NPI
Elizabeth Willard
- Pediatric Nurse Practitioner
- Seattle, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- AP61259129
- Practice address
- 4800 Sand Point Way NE
Fa.2.114 App Services
Seattle, WA 98105 - Phone
- (503) 753-5738
- NPI assigned
- Mar 22, 2022
- 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 |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | AP61259129 | WA | Primary |
Addresses
Primary practice location
4800 Sand Point Way NE
Fa.2.114 App Services
Seattle, WA 98105
Mailing address
538A Clayton St
San Francisco, CA 94117-2907
Phone (503) 753-5738
Other names 1
- Elizabeth Mattecheck
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP61259129 | WA | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Seattle Childrens Hospital | Current | Accepting new patients | |
| Seattle Children'S Hospital | Current | Accepting new patients | |
| Association of CHMC and University Physicians | Current | Accepting new patients | |
| Seattle Children'S Hospital | Current | Accepting new patients | |
| The Association of Chrmc and University Physicians | Current | Accepting new patients | |
| Seattle Children'S Hospital | Past | Accepting new patients |
Locations
1035 116th Ave NE
Bellevue, WA 98004
Phone (425) 451-4141
900 Pacific Ave
Ste 100
Everett, WA 98201
Phone (425) 304-6080
8232 W Grandridge Blvd
Kennewick, WA 99336
Phone (509) 582-1700
1711 S Jackson St
Seattle, WA 98144
Phone (206) 987-2710
4800 Sand Point Way NE
#2114
Seattle, WA 98105
Phone (206) 987-3463
4800 Sand Point Way NE
Seattle, WA 98105
Phone (206) 526-2000
1780 NW Myhre Rd
Ste 2120
Silverdale, WA 98383
Phone (360) 782-3100
Interoperability endpoints
- bwillard13489@direct.seattlechildrens.org
Organizations & group practices 6
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.
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- NPI 1851680664
-
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- NPI 1811041692
-
- Clinic Pharmacy
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- NPI 1245342153
-
- Home Infusion Agency
- Bothell, WA
- NPI 1245383348
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647907200000",
"number": "1861141376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "538A CLAYTON ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941172907",
"telephone_number": "503-753-5738"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4800 SAND POINT WAY NE",
"address_2": "FA.2.114 APP SERVICES",
"city": "SEATTLE",
"state": "WA",
"postal_code": "98105",
"telephone_number": "503-753-5738"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLARD",
"first_name": "ELIZABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-22",
"last_updated": "2022-03-22",
"certification_date": "2022-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "WA",
"license": "AP61259129",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ELIZABETH",
"last_name": "MATTECHECK",
"code": "1",
"type": "Former Name"
}
]
}
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 Mar 22, 2022; 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.