MARYANNE WAMBUI MIRIE (RN) – Psychiatric/Mental Health Nurse Practitioner, NPI 1407405657

MARYANNE WAMBUI MIRIE (RN) is a healthcare provider. based in Centralia, Washington. specializing in NURSE PRACTITIONER. They hold the professional credentials RN. They hold a License No. RN60724733 (WA). The NPI Number for MARYANNE WAMBUI MIRIE (RN) is 1407405657

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
MARYANNE WAMBUI MIRIE (RN)
NPI
1407405657
Phone
(360) 623-8020
Address
3510 Steelhammer Dr
Enumeration Date
10 September 2019
Last Update Date
26 January 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8442025555
Graduation Year
2023 (3 years ago)
PAC ID
7113455791
Group Practice PAC ID
7416233549
Professional Enrollment ID
I20250109003261
Address ID
WA982714831MA3955XNEXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness85
Years active:6State licenses:2Digital endpointsOther names

6,268 NURSE PRACTITIONER in WA

Provider Addresses for MARYANNE WAMBUI MIRIE (RN)

  • 3510 Steelhammer Dr

    Centralia, WA 985311532

    Phone: (360) 623-8020

    Type: Location

  • Josephinum, 1902, 2nd Avenue, Pike Place Market Area, Belltown, Seattle, King County, Washington, 98101, United States

    SEATTLE, WA 981011155

    Phone: (206) 956-9570

    Type: Mailing

  • JOSEPHINUM 1902 2 ND AVE, C/O CREW .

    SEATTLE, WA 98101

    Phone: (206) 956-9570

    Type: Location

  • 17224 117TH AVE E

    PUYALLUP, WA 983749393

    Phone: (206) 407-4435

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-01-09

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250109003261INurse PractitionerWATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 98531)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7416233549View full group profile
NameSpecialtyState
P S Y C H I A T R YPA
Nurse PractitionerWA
Nurse PractitionerWA
Nurse PractitionerWA
Nurse PractitionerTX
-WA
Nurse PractitionerWA
Nurse PractitionerNV
Nurse PractitionerWA
Nurse PractitionerWA

Reviews

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Frequently asked questions

Does MARYANNE WAMBUI MIRIE (RN) have a public NPI I can cite?
Public records show MARYANNE WAMBUI MIRIE (RN) under NPI 1407405657.
Does the public listing show MARYANNE WAMBUI MIRIE (RN) as active?
MARYANNE WAMBUI MIRIE (RN)'s NPI record reflects an active status in NPPES.
What services align with MARYANNE WAMBUI MIRIE (RN)'s listing?
MARYANNE WAMBUI MIRIE (RN)'s public classification highlights Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Which community is linked to MARYANNE WAMBUI MIRIE (RN)?
MARYANNE WAMBUI MIRIE (RN) shows a connection to Centralia, Washington in registry-derived data.
Who maintains MARYANNE WAMBUI MIRIE (RN)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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