Individual provider Active NPI

Rebecca Brunk, MSN, APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Vancouver, WA
National Provider Identifier
1962279596
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP61648446 Issued in WA
Practice address
10604 NE Highway 99
Vancouver, WA 98686-5613
Phone
(360) 644-1631
Fax
(360) 644-1655
NPI assigned
Dec 5, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN61318937 WA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 10038388 OR
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP61648446 WA Primary

Addresses

Primary practice location

10604 NE Highway 99
Vancouver, WA 98686-5613

Mailing address

10604 NE Highway 99
Vancouver, WA 98686-5613
Phone (360) 644-1631

Other practice location 1

9300 NE Oak View Dr
Vancouver, WA 98662-6157
Phone (360) 567-2211

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
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
RN61318937WAMDRegistered Nurse
10038388ORMDPsychiatric/Mental Health Nurse Practitioner
AP61648446WAMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1701734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1962279596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10604 NE HIGHWAY 99",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986865613",
            "telephone_number": "360-644-1631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10604 NE HIGHWAY 99",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986865613",
            "telephone_number": "360-644-1631",
            "fax_number": "360-644-1655"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9300 NE Oak View Dr",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986626157",
            "country_code": "US",
            "telephone_number": "360-567-2211",
            "fax_number": "360-567-2212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUNK",
        "first_name": "REBECCA",
        "credential": "MSN, APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-05",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN61318937",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "10038388",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61648446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.