Robert Cecil Groetken, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP61247918 Issued in WA

Practice address

4004 Sunset Dr W
University Place, WA 98466-2405

Phone

(206) 251-1733

NPI assigned

Dec 2, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Cognitive Growth Mental Health

  • Adult Mental Health Clinic/Center
  • Fircrest, WA
  • NPI 1871243808
  NPD Authorized official

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

{
    "created_epoch": "1638403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1992463376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 BRIDGEPORT WAY W",
            "address_2": "STE A #302",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984664495",
            "telephone_number": "206-251-1733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4004 SUNSET DR W",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984662405",
            "telephone_number": "206-251-1733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROETKEN",
        "first_name": "ROBERT",
        "middle_name": "CECIL",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-12-02",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61247918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaron Amon Greene
• Gregory J Wiles DC PS
• Jenifer Gregory, PHD
• Daniel Paul Grey, LICSW
• Vicki Lynn Grimes, ARNP
• Jeanne L. Groff, LMFT
• Stephen Conrad Groo, MD
• Guardian Home Care
• Jessica Alejandra Gudino, CNA
• Mariette Guidry, LMFT

• Psychiatric/Mental Health Nurse Practitioner in University Place, WA
• Providers in University Place, 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 Dec 15, 2021; 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.