Individual provider Active NPI

Nicole Deboer, ARNP

  • Family Nurse Practitioner
  • Bend, OR
National Provider Identifier
1861191702
Registry record updated Apr 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP61478766 Issued in WA
Practice address
2200 NE Neff Rd Ste 302
Bend, OR 97701-4279
Phone
(541) 706-6915
Fax
(541) 706-6733
NPI assigned
Feb 28, 2023
Last updated
Apr 24, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP61478766 WA Primary
Registered Nurse 163W00000X RN61095221 WA

Addresses

Primary practice location

2200 NE Neff Rd Ste 302
Bend, OR 97701-4279

Mailing address

12040 NE 128TH St
Kirkland, WA 98034-3013

Other practice location 1

12040 NE 128th St
Kirkland, WA 98034-3013
Phone (425) 899-1000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ndeboer231887@secure.stcharleshealthcare.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20231114000861 WA Practitioner - Nurse Practitioner 1355798372 Reassigns benefits to 1 organization
I20260505002924 OR Practitioner - Nurse Practitioner 1355798372 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Charles Health System IncGroup PAC ID 8729111513, 379 clinicians

Practice addresses (Care Compare)

12333 NE 130TH LN
Suite 400
Kirkland, WA 98034-7467
Phone (425) 899-6414

2200 NE Neff Rd
Bend, OR 97701-4283
Phone (541) 382-4321

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.73 of 100Reported as apm
Quality
73.46
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN61095221WAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
King County Public Hospital District No. 2 CurrentSince Nov 1, 2023 Accepting new patients
King County Public Hospital District No 2 CurrentSince Nov 1, 2023 Accepting new patients
King County Public Hospital District No 2 Current Accepting new patients
King County Public Hospital District No 2 Past Accepting new patients

Locations

12040 NE 128th St
Kirkland, WA 98034
Phone (425) 899-1000

12040 NE 128th St
#50
Kirkland, WA 98034
Phone (425) 899-1894

12333 NE 130th Ln
Ste 400
Kirkland, WA 98034
Phone (425) 216-4220

Interoperability endpoints

  • Direct secure messaging: ndeboer231887@secure.stcharleshealthcare.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1677542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776988800000",
    "number": "1861191702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12040 NE 128TH ST",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 NE NEFF RD STE 302",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014279",
            "telephone_number": "541-706-6915",
            "fax_number": "541-706-6733"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12040 NE 128th St",
            "address_purpose": "LOCATION",
            "city": "Kirkland",
            "state": "WA",
            "postal_code": "980343013",
            "country_code": "US",
            "telephone_number": "425-899-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEBOER",
        "first_name": "NICOLE",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-28",
        "last_updated": "2026-04-24",
        "certification_date": "2026-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61478766",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN61095221",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ndeboer231887@secure.stcharleshealthcare.org",
            "affiliation": "N",
            "address_1": "2200 NE Neff Rd Ste 302",
            "city": "Bend",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977014279",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.