Individual provider Active NPI

Winnie Deechakawan-Miller, PHD, DNP, ARNP

  • Nurse Practitioner
  • Seattle, WA
National Provider Identifier
1992195275
Registry record updated Mar 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP60535703 Issued in WA
Practice address
1530 N 115TH St Ste 110
Seattle, WA 98133-8411
Phone
(206) 701-6545
NPI assigned
Jan 26, 2015
Last updated
Mar 22, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP60535703 WA Primary

Addresses

Primary practice location

1530 N 115TH St Ste 110
Seattle, WA 98133-8411

Mailing address

1530 N 115TH St Ste 110
Seattle, WA 98133-8411
Phone (206) 701-6545

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20190812000770 TX Practitioner - Nurse Practitioner 3971802364 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
AP60535703WAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tulalip Tribes of Washington CurrentSince Jun 18, 2019 Accepting new patients
Tulalip Tribes of Washington CurrentSince Jun 18, 2019 Accepting new patients
Summit Cardiology, P.S. Past Accepting new patients

Locations

6406 Marine Dr
Ste A
Tulalip, WA 98271

7520 Totem Beach Rd
Tulalip, WA 98271
Phone (360) 651-4511

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1422230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490140800000",
    "number": "1992195275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 N 115TH ST STE 110",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981338411",
            "telephone_number": "206-701-6545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 N 115TH ST STE 110",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981338411",
            "telephone_number": "206-701-6545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEECHAKAWAN-MILLER",
        "first_name": "WINNIE",
        "name_prefix": "Dr.",
        "credential": "PHD, DNP, ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-26",
        "last_updated": "2017-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP60535703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.