MIDWEST MENTAL HEALTH CLINIC PLLC
NPI 1184338824
Nurse Practitioner - Psychiatric/Mental Health in Seattle, WA
About Midwest Mental Health Clinic Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MIDWEST MENTAL HEALTH CLINIC PLLC (NPI 1184338824), doing business as Grey Matters Mental Health Clinic, is a healthcare organization registered as a psychiatric/mental health in Seattle, Washington and active in the NPI registry since January 2023. The organization holds a CLIA Waiver certificate valid through May 25, 2028 and lists Jacqualine Kay Gervais, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Group Practice 1
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 35D2261130
Midwest Mental Health Clinic, PLLC · Fargo, NDFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Midwest Mental Health Clinic PLLC's NPI number?
The NPI number for Midwest Mental Health Clinic PLLC is 1184338824. It was assigned to this organization in the NPPES registry on January 9, 2023. The provider is doing business as Grey Matters Mental Health Clinic.
Where is Midwest Mental Health Clinic PLLC located?
Midwest Mental Health Clinic PLLC is located at 5306 Ballard Ave NW Ste 208, Seattle, WA 98107. The listed phone number is (206) 607-9205.
What is Midwest Mental Health Clinic PLLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Does Midwest Mental Health Clinic PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 35D2261130) is associated with this NPI, valid through May 25, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Midwest Mental Health Clinic PLLC was last updated on January 9, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Midwest Mental Health Clinic Pllc · NPI 1184338824
Psychiatric/Mental Health organization in Seattle, Washington. Organization record, active in the CMS NPPES registry since January 9, 2023.
## Identity
- **NPI:** 1184338824 (Entity type: Organization)
- **Enumerated:** January 9, 2023
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **Also known as:** Grey Matters Mental Health Clinic (Doing Business As)
- **Organization subpart:** Yes (part of Midwest Mental Health Clinic Pllc)
- **Authorized official:** Jacqualine Gervais, OWNER
## Practice location
- **Address:** 5306 BALLARD AVE NW STE 208, Seattle, WA 98107-4366
- **Phone:** (206) 607-9205
## Record status
- **NPPES last updated:** January 9, 2023
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1184338824) · Data from the CMS NPPES public registry.