Individual provider Active NPI

Mikayla Mae Mannis, LPN

  • Licensed Practical Nurse
  • Olympia, WA
National Provider Identifier
1942162292
Registry record updated Nov 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
89259 Issued in TN
Practice address
6700 Martin Way E Ste 117
Olympia, WA 98516-5586
Phone
(360) 413-6910
NPI assigned
Nov 25, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 89259 TN Primary

Addresses

Primary practice location

6700 Martin Way E Ste 117
Olympia, WA 98516-5586

Mailing address

4910 Orvas CT SE
Olympia, WA 98501-4764
Phone (423) 444-5999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
89259TNMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1764028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764028800000",
    "number": "1942162292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4910 ORVAS CT SE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985014764",
            "telephone_number": "423-444-5999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6700 MARTIN WAY E STE 117",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985165586",
            "telephone_number": "360-413-6910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNIS",
        "first_name": "MIKAYLA",
        "middle_name": "MAE",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-25",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "TN",
            "license": "89259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 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.