Audrey Jean Church, ARNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP30004413 Issued in WA

Practice address

2344 NE Marion LN
Issaquah, WA 98029-3661

Phone

(206) 778-9737

Fax

(425) 391-7014

NPI assigned

Oct 17, 2006

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

Other identifiers 1

Other names 1

• Audrey Jean Laxton Former name

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

Specialty

Nurse Practitioner

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Western Psychological and Counseling Services LLCGroup PAC ID 7719975085, 331 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: lifestancehealth.audreychurch@147765.advancedmd-direct.com

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.

• Western Psychological and Counseling Services LLC

  • Clinical Psychologist
  • Vancouver, WA
  • NPI 1629345731
  Medicare reassignment Care Compare group
• Kris S. Morgan, PH.D. PS

  • Psychologist
  • Seattle, WA
  • NPI 1558316950
  NPD (past)
• Public Hospital District 1 of King County

  • Institutional Pharmacy
  • Renton, WA
  • NPI 1679862189
  NPD (past)
• Western Psychological and Counseling Services LLC

  • Clinical Psychologist
  • Tacoma, WA
  • NPI 1912008178
  NPD (past)

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587686400000",
    "number": "1972683571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2344 NE MARION LN",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980293661",
            "telephone_number": "206-778-9737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2344 NE MARION LN",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980293661",
            "telephone_number": "206-778-9737",
            "fax_number": "425-391-7014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHURCH",
        "first_name": "AUDREY",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2020-04-24",
        "certification_date": "2020-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP30004413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9625377",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AUDREY",
            "last_name": "LAXTON",
            "middle_name": "JEAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Anne Marie Christensen, LMP
• Matthew Wittaya Scott Christensen, DPT
• Christian P Manley
• Christina Schiller OD PLLC
• Yajing Chu, PHARMD
• Artem Chuvashov, DDS
• Yelena Chuvashova, DDS
• Caroline Ciesko
• Nicole Citragno
• Elaine M Clark, MPT

• Psychiatric/Mental Health Nurse Practitioner in Issaquah, WA
• Providers in Issaquah, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.