TRISTA NICOLE MORTENSEN (MSW) – Clinical Social Worker, NPI 1720125636

TRISTA NICOLE MORTENSEN (MSW) is a healthcare provider. based in Renton, Washington. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials MSW. They hold a License No. LW60004175 (WA). The NPI Number for TRISTA NICOLE MORTENSEN (MSW) is 1720125636

Main info

Female
Sole Proprietor
27 Years Of Experience
Accepts Medicare Assignment
Name
TRISTA NICOLE MORTENSEN (MSW)
NPI
1720125636
Phone
(206) 697-3281
Address
304 MAIN AVE S
Enumeration Date
31 January 2007
Last Update Date
1 October 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2066973281
Graduation Year
1999 (27 years ago)
PAC ID
5991959363
Professional Enrollment ID
I20130212000369
Address ID
WA980572758RE304XXSXXX402
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,396 CLINICAL SOCIAL WORKER in WA

Provider Addresses for TRISTA NICOLE MORTENSEN (MSW)

  • 304 MAIN AVE S

    STE 102

    RENTON, WA 980572758

    Phone: (206) 697-3281

    Fax: (206) 358-5753

    Type: Mailing

  • 916, North 1st Street, North Renton, Renton, King County, Washington, 98057, United States

    RENTON, WA 980575759

    Phone: (206) 697-3281

    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: 2013-02-12

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
I20130212000369IClinical Social WorkerWATBD

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 98057)

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Reviews

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Frequently asked questions

Can I cross-check TRISTA NICOLE MORTENSEN (MSW) using NPI 1720125636?
NPI 1720125636 belongs to TRISTA NICOLE MORTENSEN (MSW); compare other details if you need extra assurance.
Is TRISTA NICOLE MORTENSEN (MSW) still an active registrant?
TRISTA NICOLE MORTENSEN (MSW) carries an active NPI according to the public dataset.
What area of care is associated with TRISTA NICOLE MORTENSEN (MSW)?
TRISTA NICOLE MORTENSEN (MSW)'s record emphasizes Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Is TRISTA NICOLE MORTENSEN (MSW) located near Renton?
TRISTA NICOLE MORTENSEN (MSW) currently maps to Renton, Washington in this extract.
What does 4 location(s) imply?
4 practice locations appear in the available data.

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