Individual provider Active NPI

Colette Cristine Spencer, ARNP

  • Nurse Practitioner
  • Seattle, WA
National Provider Identifier
1972808491
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP60326660 Issued in WA
Practice address
9776 Holman Road NW
Suite 102
Seattle, WA 98117
Phone
(206) 524-0033
Fax
(206) 524-0035
NPI assigned
Jan 13, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2021

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 RN60109880 WA
Psychiatric/Mental Health Registered Nurse 163WP0808X RN60109880 WA
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X RN60109880 WA
Nurse Practitioner 363L00000X AP60326660 WA Primary

Addresses

Primary practice location

9776 Holman Road NW
Suite 102
Seattle, WA 98117

Mailing address

9776 Holman Road NW
Suite 102
Seattle, WA 98117
Phone (206) 524-0033

Other practice location 1

9800 4th Ave NE
Seattle, WA 98115-2152
Phone (206) 302-1200

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync Health Information Exchange (HIE)

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
I20131113001200 WA Practitioner - Nurse Practitioner 1850527284 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaiser Foundation Health Plan of WashingtonGroup PAC ID 9032022579, 1,519 clinicians

Practice addresses (Care Compare)

9800 4TH Ave NE
Seattle, WA 98115-2152
Phone (206) 527-7100

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of Washington CurrentSince Oct 25, 2017 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Oct 25, 2017 Accepting new patients

Locations

19379 7th Ave NE
Poulsbo, WA 98370
Phone (360) 394-1000

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

9800 4th Ave NE
Seattle, WA 98115
Phone (206) 302-1200

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Interoperability endpoints

  • Direct secure messaging: cspencer84650@ghc.direct-ci.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1294876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1972808491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9776 HOLMAN ROAD NW",
            "address_2": "SUITE 102",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98117",
            "telephone_number": "206-524-0033",
            "fax_number": "206-524-0035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9776 HOLMAN ROAD NW",
            "address_2": "SUITE 102",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98117",
            "telephone_number": "206-524-0033",
            "fax_number": "206-524-0035"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9800 4th Ave NE",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981152152",
            "country_code": "US",
            "telephone_number": "206-302-1200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "COLETTE",
        "middle_name": "CRISTINE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-13",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60109880",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "WA",
            "license": "RN60109880",
            "primary": false
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "WA",
            "license": "RN60109880",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP60326660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
            "affiliation": "N",
            "endpointDescription": "carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9800 4th Ave NE",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981152152",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.