Individual provider Active NPI

Wenjia Song, ARNP

  • Family Nurse Practitioner
  • Sammamish, WA
National Provider Identifier
1871901546
Registry record updated Feb 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP 60406859 Issued in WA
Practice address
22707 SE 29TH St
Sammamish, WA 98075-9532
Phone
(425) 392-3961
NPI assigned
Jul 25, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN 60009346 WA
Family Nurse Practitioner 363LF0000X AP 60406859 WA Primary

Addresses

Primary practice location

22707 SE 29TH St
Sammamish, WA 98075-9532

Mailing address

22707 SE 29TH St
Sammamish, WA 98075-9532
Phone (425) 455-2845

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141219000731 WA Practitioner - Nurse Practitioner 4385967504 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Swedish Health ServicesGroup PAC ID 9537072814, 384 clinicians

Practice addresses (Care Compare)

22707 SE 29TH St
Sammamish, WA 98075-9532
Phone (425) 455-2845

2450 33Rd Ave W
Suite 100
Seattle, WA 98199-3252
Phone (206) 320-3364

Hospital & facility affiliations

  • Swedish Issaquah Hospital, Issaquah, WA, CCN 500152

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN 60009346WAMDRegistered Nurse
AP 60406859WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Swedish Health Services CurrentSince Nov 1, 2014 Accepting new patients
Swedish Health Services Registered Nurse CurrentSince Nov 1, 2014 Accepting new patients

Locations

751 NE Blakely Dr
Ste 4020
Issaquah, WA 98029
Phone (425) 313-7077

22707 SE 29th St
Sammamish, WA 98075
Phone (425) 455-2845

600 University St
Ste 1200
Seattle, WA 98101
Phone (206) 320-2568

2450 33rd Ave W
Ste 100
Seattle, WA 98199
Phone (206) 320-3364

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1406246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612396800000",
    "number": "1871901546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22707 SE 29TH ST",
            "city": "SAMMAMISH",
            "state": "WA",
            "postal_code": "980759532",
            "telephone_number": "425-455-2845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22707 SE 29TH ST",
            "city": "SAMMAMISH",
            "state": "WA",
            "postal_code": "980759532",
            "telephone_number": "425-392-3961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "WENJIA",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-25",
        "last_updated": "2021-02-04",
        "certification_date": "2021-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN 60009346",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP 60406859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sammamish, WA

Sources for this page

Verify at the official NPI Registry.