Select Mental Health – Psychiatric/Mental Health Nurse Practitioner, NPI 1184269839
Psychiatric/Mental Health Nurse Practitioner
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Select Mental Health
8415 MYERS RD E
BONNEY LAKE, WA 983917043
Phone: (253) 470-8078
Fax: (253) 248-0139
Type: Location
15324 MAIN ST E STE B
SUMNER, WA 983902698
Phone: (253) 470-8078
Type: Location
17914 46TH DR SE
BOTHELL, WA 980127585
Phone: (253) 470-8078
Type: Mailing
28002 STATE ROUTE 410 E STE 5
BUCKLEY, WA 983217516
Phone: (253) 470-8078
Fax: (253) 248-0139
Type: Location
PO BOX 7023
BONNEY LAKE, WA 983910700
Phone: (253) 470-8078
Fax: (253) 248-0139
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: 2020-02-24
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2026-05-31 (8 days ago).
Enrollment records
1
Earliest due date
2026-05-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20200224002199 | O | Clinic/Group Practice | WA | 2026-05-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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 98391)
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