DEEP BRAIN STIMULATION TR (NPI# 1063740058) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063740058 |
| Entity Type | Organization |
| Organization Name | DEEP BRAIN STIMULATION TR |
| Practice Address |
1560 N 115th St Suite G-5 Seattle WA 98133-8414 |
| Practice Telephone | 2063685935 |
| Practice Fax Number | 2063685934 |
| Mailing Telephone | 2063685935 |
| Mailing Fax Number | 2063685934 |
| Enumeration Date | 2009-12-02 |
| Last Update Date | 2011-04-04 |
| Authorized Official Name | CHARLES WILLIAM SCHNEIDER (CEO) |
| Authorized Official Telephone | 2063681700 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1560 N 115TH ST SUITE G-5 |
| City | SEATTLE |
| State | WA |
| Zip Code | 98133-8414 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275539546 | Helena B Jones | Internal Medicine | 1560 N 115th St, Ste G-10, Seattle, WA 98133-8414 | 2005-06-22 |
| 1386084903 | Derman Pllc | General Acute Care Hospital | 1560 N 115th St, Suite 201, Seattle, WA 98133-8414 | 2013-06-27 |
| 1164782975 | Northwest Obstetrics & Gynecology | Obstetrics & Gynecology | 1560 N 115th St, Suite 109, Seattle, WA 98133-8414 | 2012-05-25 |
| 1104185644 | Johnathon Curtis Rollo | Surgery | 1560 N 115th St, Seattle, WA 98133-8414 | 2012-05-03 |
| 1861780264 | Teresa Lynn Gegax-martinez | Nurse Practitioner | 1560 N 115th St, Ms W-201, Seattle, WA 98133-8414 | 2011-07-19 |
| 1184917569 | Pacific Medical, Inc. | Durable Medical Equipment & Medical Supplies | 1560 N 115th St, Suite G-10, Seattle, WA 98133-8414 | 2011-05-18 |
| 1295056323 | Paul Samuel Martin | Internal Medicine | 1560 N 115th St, Seattle, WA 98133-8414 | 2010-06-11 |
| 1518297308 | Wound Care Center Tr | Nurse Practitioner | 1560 N 115th St, Suite 201, Seattle, WA 98133-8414 | 2009-12-30 |
| 1700016391 | Nilufer B Norsworthy | Internal Medicine | 1560 N 115th St, Suite 201, Seattle, WA 98133-8414 | 2009-07-17 |
| 1720218514 | Bijan Justin Ghassemieh | Internal Medicine | 1560 N 115th St, Suite G10, Seattle, WA 98133-8414 | 2009-07-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891339388 | Marni Lynn Hanig | Occupational Therapist | 1900 N 170th St., Shoreline, WA 98133 | 2019-10-29 |
| 1871074807 | Minju Kim | Counselor | 14332 Burke Ave N, Seattle, WA 98133 | 2018-08-27 |
| 1821582941 | Hana Alema Misgina | Registered Nurse | 927 N 199th St, Shoreline, WA 98133 | 2018-06-21 |
| 1588177729 | Julie Benefiel | Pharmacist | 1536 N 115th St. Suite 100, Seattle, WA 98133 | 2017-11-09 |
| 1730607953 | Aurora Oaks, LLC | Skilled Nursing Facility | 16357 Aurora Avenue North, Shoreline, WA 98133 | 2017-09-08 |
| 1750801072 | Zoe Ana Cavnar-lewandowski | Counselor | 10700 Meridian Avenue N, Suite G-11, Seattle, WA 98133 | 2017-06-27 |
| 1851820211 | Adam Lee Gardner Sr. | Acupuncturist | 925 N 163rd Street, Unit B, Shoreline, WA 98133 | 2017-06-08 |
| 1376085209 | Pamela Ashby | Counselor | 2111 N. Northgateway, 212, Seattle, WA 98133 | 2016-11-09 |
| 1225584956 | General Dentistry | Dentist | 20109 Aurora Ave N, Ste D, Shoreline, WA 98133 | 2016-09-01 |
| 1144672668 | Aaron Neubauer | Behavioral Analyst | 13407 Greenwood Ave N, 216c, Seattle, WA 98133 | 2016-07-08 |
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| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548871007 | Holly Jean Irvin | Nurse Practitioner | 701 5th Ave N Unit 323, Seattle, WA 98109-5100 | 2020-08-10 |
| 1164080602 | Abigail Bracken | Nurse Practitioner | 2713 S Elmwood Pl, Seattle, WA 98144-3131 | 2019-05-30 |
| 1447813589 | Maria Elena Ovalles Van Gaver | Nurse Practitioner | 1604 14th Ave, Seattle, WA 98122-4026 | 2019-04-15 |
| 1043788292 | Zechariah T Thiry | Nurse Practitioner | 1600 2nd Ave Apt 811, Seattle, WA 98101-3278 | 2018-11-06 |
| 1124503974 | Katrina Korreckt | Nurse Practitioner | 135 Nw 76th St, Seattle, WA 98117-3016 | 2018-09-27 |
| 1275011470 | Amber Lynn Hawkins | Nurse Practitioner | 11531 Bartlett Ave Ne, Seattle, WA 98125-5832 | 2018-07-31 |
| 1346748985 | Thu Van Nguyen | Nurse Practitioner | 317 Ne Thornton Pl Ste 10a, Seattle, WA 98125-8020 | 2018-01-29 |
| 1356860886 | Taylor Donovan | Nurse Practitioner | 509 Olive Way Ste 752, Seattle, WA 98101-3171 | 2017-09-15 |
| 1215454574 | Shannon Duffy | Nurse Practitioner | 12704 76th Ave S, Seattle, WA 98178-4811 | 2017-08-28 |
| 1215458674 | Melissa Mary Fessel | Nurse Practitioner | 601 Broadway Ste 600, Seattle, WA 98122-5330 | 2017-07-06 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.