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NPI Code Detail

MEDICARE: AGNES MBATIA ARNP

MEDICARE: AGNES MBATIA ARNP
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 PractitionerAP70075749WA

General Provider Information

NPI Number : 1477417889
Entity Type Code : Individual
Provider Name (Legal Business Name) : AGNES MBATIA ARNP
Provider Business Mailing Address
First Line : 10123 21ST ST SE
Second Line :
City : LAKE STEVENS
State : WA
Zip : 98258-3223
Country : US
Telephone Number : 206-422-7742
Fax Number :
Provider Business Practice Location Address
First Line : 21907 64TH AVE W STE 200
Second Line :
City : MOUNTLAKE TERRACE
State : WA
Zip : 98043-6200
Country : US
Telephone Number : 425-578-5144
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/10/2025
Last Update Date : 12/10/2025

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