DR. DEJANIQUE SHERIA NORTHWAYDE
NPI 1285574566
Student in an Organized Health Care Education/Training Program in Vancouver, WA

Q: What is Dejanique Northwayde's NPI number?

The NPI number for Dejanique Northwayde is 1285574566. It was assigned to this individual provider in the NPPES registry on March 30, 2026. The provider is also known as Dr. Dejanique Northwayde MD.

Q: What is Dejanique Northwayde's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Active since March 30, 2026PECOS Enrolled

2211 NE 139TH ST, VANCOUVER, WA 98686(360) 397-1985(360) 604-1604 Get Directions Write a Review

NPPES record last updated: April 23, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 23, 2026, Mar 30, 2026 (2 updates tracked since 2026).

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About Dr. Dejanique Sheria Northwayde NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. DEJANIQUE SHERIA NORTHWAYDE (NPI 1285574566) is an individual student in an organized health care education/training program in Vancouver, Washington and active in the NPI registry since March 2026. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1285574566

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameDR. DEJANIQUE SHERIA NORTHWAYDE

Location Address2211 NE 139TH STVancouver, WA 98686-2742

Mailing Address9524 Interlake Ave N Unit BSeattle, WA 98103-3324 · (360) 904-0244

Phone(360) 397-1985

Fax(360) 604-1604

Sole ProprietorNo

Enumeration DateMarch 30, 2026

Last NPPES UpdateApril 23, 20262 updates tracked since enumeration

NPPES CertifiedApril 23, 2026

✔ NPI 1285574566 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

2211 NE 139TH ST, Vancouver, WA 98686

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Other Names 1

Other Name (5)Dr. Dejanique Northwayde Md

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Dejanique Sheria Northwayde is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. NATALIA SAYURI MUTO MD

Student in an Organized Health Care Education/Training Program