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NPI Code Detail

MEDICARE: CANDACE MABBITT CNM, WHNP-BC, PMHNP

MEDICARE: CANDACE MABBITT CNM, WHNP-BC, PMHNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse PractitionerAP61574928WA
2367A00000XAdvanced Practice MidwifeAP 60576932WA

General Provider Information

NPI Number : 1265841159
Entity Type Code : Individual
Provider Name (Legal Business Name) : CANDACE MABBITT CNM, WHNP-BC, PMHNP
Provider Business Mailing Address
First Line : 15260 NE 15TH PL APT B
Second Line :
City : BELLEVUE
State : WA
Zip : 98007-4592
Country : US
Telephone Number : 623-256-7609
Fax Number :
Provider Business Practice Location Address
First Line : 6553 CALIFORNIA AVE SW STE B
Second Line :
City : SEATTLE
State : WA
Zip : 98136-1896
Country : US
Telephone Number : 206-659-7299
Fax Number : 206-659-7299
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2014
Last Update Date : 02/10/2025

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