Imanie Marie Forest, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

61438532 Issued in WA

Practice address

3436 Mary Elder Rd NE
Olympia, WA 98506-5050

Phone

(360) 528-2590

NPI assigned

Feb 18, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1739836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1871398396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4318 S PUGET SOUND AVE UNIT 2B",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984094538",
            "telephone_number": "253-325-9322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3436 MARY ELDER RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065050",
            "telephone_number": "360-528-2590"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4318 S Puget Sound Ave Unit 2B",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984094538",
            "country_code": "US",
            "telephone_number": "253-325-9322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOREST",
        "first_name": "IMANIE",
        "middle_name": "MARIE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-18",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "61438532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jutta Fonseca, MA61091263
• Princewill Fonta, PMHNP
• Larry L Fontanilla Jr., MD
• Ahmad Fora, MD
• Forest Shores Capital
• Elizabeth Forman Serdar, ARNP
• Celia G Forno, PMHNP
• Ian Ferguson Forster
• Samantha Rosa Forster
• Ashley Nicole Forsythe

• Registered Nurse in Olympia, WA
• Providers in Olympia, WA by specialty
• Registered Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2025; 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.