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YELLOW BRICK CLINIC PLLC NPI 1932687704


NPI Information

NPI: 1932687704
Provider Name: YELLOW BRICK CLINIC PLLC

Doing Business As: YELLOW BRICK CLINIC

Classification: Nurse Practitioner - 363LP0808X
Entity Type: Organization

Specialization: Psychiatric/Mental Health

Address:
DO NOT PUBLISH
RENTON, WA
ZIP 98056
Phone: (425) 777-5467
Get Directions

YELLOW BRICK CLINIC PLLC is a psychiatric/mental health nurse practitioner in Renton, WA. YELLOW BRICK CLINIC PLLC NPI is 1932687704. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Yellow Brick Clinic.

The provider's business location address is:

DO NOT PUBLISH
RENTON, WA
ZIP 98056-715
Phone: (425) 777-5467
Fax: (833) 631-6941

The provider's authorized official is Kathleen Elizabeth Johnson .
The authorized official title is Nurse Practitioner and has the following contact phone number (425) 777-5467.

The enumeration date for this NPI number is 8/2/2018 and was last updated on 4/27/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363L00000XNurse PractitionerNo
2363LF0000XNurse PractitionerFamilyAP60786815WASHINGTONNo
3363LF0000XNurse PractitionerFamilyNo
4363LP0200XNurse PractitionerPediatricsNo
5363LP0808XNurse PractitionerPsychiatric/Mental HealthYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12090206MEDICAIDWASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024
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