Provider Demographics
NPI:1427605609
Name:WAINAINA, MERCY N (DNP-PMHNP)
Entity Type:Individual
Prefix:DR
First Name:MERCY
Middle Name:N
Last Name:WAINAINA
Suffix:
Gender:F
Credentials:DNP-PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4630 200TH ST SW STE F
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-6608
Mailing Address - Country:US
Mailing Address - Phone:425-510-1196
Mailing Address - Fax:425-582-8966
Practice Address - Street 1:4630 200TH ST SW STE F
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-6608
Practice Address - Country:US
Practice Address - Phone:425-510-1196
Practice Address - Fax:425-582-8966
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-21
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM0801X
WAAP60992356363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA217358300Medicaid
WA1073198602OtherTYPE 2 NPI