Organization Active NPI

Nurturing Minds Wa PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Lynnwood, WA
National Provider Identifier
1891573408
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
NURTURING MINDS WA PLLC
Practice address
17415 52ND Ave W Unit 4
Lynnwood, WA 98037-3082
Phone
(206) 330-4022
NPI assigned
Sep 15, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2025

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

Authorized official

Name
Patrick C Eneje, DNP, PMHNP-BCNPI 1124710140
Title
Director
Phone
(615) 693-8471

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

17415 52ND Ave W Unit 4
Lynnwood, WA 98037-3082

Mailing address

300 Lenora St # 6083
Seattle, WA 98121-2411
Phone (206) 330-4022

Other practice location 1

608 Applejack Ct
Antioch, TN 37013-4893
Phone (615) 693-8471

Other practice location 2

1905 Sherman Street Ste 200 #2029
Denver, CO 80203
Phone (206) 330-4022

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241220000416 WA Part B Supplier - Clinic/Group Practice 5799212387 Receives reassigned benefits from 1 practitioner
Practice locations: Lynnwood, WA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1694736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743379200000",
    "number": "1891573408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 LENORA ST # 6083",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981212411",
            "telephone_number": "206-330-4022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17415 52ND AVE W UNIT 4",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980373082",
            "telephone_number": "206-330-4022"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "608 Applejack Ct",
            "address_purpose": "LOCATION",
            "city": "Antioch",
            "state": "TN",
            "postal_code": "370134893",
            "country_code": "US",
            "telephone_number": "615-693-8471",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1905 Sherman Street Ste 200 #2029",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "80203",
            "country_code": "US",
            "telephone_number": "206-330-4022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NURTURING MINDS WA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-15",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-26",
        "status": "A",
        "authorized_official_last_name": "ENEJE",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "615-693-8471",
        "authorized_official_credential": "DNP, PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.