Individual provider Active NPI

Matthew Gatheringwater, RN

  • Registered Nurse
  • Port Angeles, WA
National Provider Identifier
1982477527
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN60259990 Issued in WA
Practice address
939 Caroline St
Port Angeles, WA 98362-3909
Phone
(360) 417-7315
Fax
(360) 452-3531
NPI assigned
Nov 6, 2023
Last updated
Nov 6, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN60259990 WA Primary

Addresses

Primary practice location

939 Caroline St
Port Angeles, WA 98362-3909

Mailing address

939 Caroline St
Port Angeles, WA 98362-3909
Phone (360) 417-7315

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN60259990WAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1699228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1982477527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "939 CAROLINE ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983623909",
            "telephone_number": "360-417-7315",
            "fax_number": "360-452-3531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "939 CAROLINE ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983623909",
            "telephone_number": "360-417-7315",
            "fax_number": "360-452-3531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATHERINGWATER",
        "first_name": "MATTHEW",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-06",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60259990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Angeles, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; 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.