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Elizabeth Miyu Blake , ARNP

Nurse Practitioner - Pediatrics β€’ Pasco, WA

Active NPI 1639103237 Individual Practitioner Female Practitioner
Practice location in NPPES

301 N 10th Ave
Pasco, WA 993015480

Call 5095472429 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

301 N 10th Ave

Pasco, WA 993015480

Telephone 5095472429
Other Listings in Public Data

NPPES lists 2 distinct additional practice-address records in Seattle, WA; Silverdale, WA. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

Industry payments (Open Payments)

No Open Payments records are listed for this clinician for 2021–2025.

Guide: How to read an Open Payments record

NPI first issued

2006

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Pasco and Washington

2 active clinicians are listed under Nurse Practitioner - Pediatrics with a practice address in Pasco, WA (502 in Washington).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Nurse Practitioner - Pediatrics Primary Specialty

NUCC Taxonomy Code: 363LP0200X

License # reported to NPPES WA AP30003638
Nurse Practitioner - Pediatrics

NUCC Taxonomy Code: 363LP0200X

License # reported to NPPES WA RN00118189
Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Washington State Department of Health Provider Lookup.
Look Up on State Board Site

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid ID
9620097 (WA)
Other Identifier Arnp License
AP30003638 (WA)
Other Identifier Rn License
RN00118189 (WA)

Secondary Practice Locations

501 -- 5th Ave

Seattle, WA 98104

Phone: 2062964600

9951 Mickelberry Rd Nw, Ste 101

Silverdale, WA 983838309

Phone: 3606929362

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

8 Historical Events
πŸ“
Updated Practice Location April 19, 2019

Registered at 301 N 10TH AVE, PASCO, WA 993015480 (Tel: 5095472429)

πŸ“
Updated Business Mailing Address April 19, 2019

Registered at 128 WOODLAND AVE, PORT TOWNSEND, WA 983685049 (Tel: 2064224035)

βœ…
NPI Profile Active December 28, 2011

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) December 28, 2011

Registered at 9951 MICKELBERRY RD NW, STE 101, SILVERDALE, WA 983838309 (Tel: 3606929362)

πŸ“
Business Mailing Address (Initial Record) December 28, 2011

Registered at 9951 MICKELBERRY RD NW, STE 101, SILVERDALE, WA 983838309 (Tel: 3606929362)

πŸ‘€
Provider Name / Credentials (Initial Record) December 28, 2011

Recorded as ELIZABETH BLAKE, ARNP

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) December 28, 2011

Nurse Practitioner (license number reported to NPPES: WA AP30003638)

🟒
Initial NPI Registration & Enumeration July 10, 2006

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1639103237
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 10, 2006
Last Update: March 07, 2023
Sole Proprietor: No

Mailing Address

128 Woodland Ave

Port Townsend, WA 983685049

Phone: 2064224035

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.