Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Vivian Kisanga, PMHNP-BC

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1821530155

Vivian Kisanga, PMHNP-BC is a Nurse Practitioner in Puyallup, Washington. Qualified in 2016, 10 years ago. Practices with Mindful Therapy Group PC, a 646-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Texas and Washington.

Years since qualifying
10
Licensed in
TX, WA
In the registry since
2016
Specialties on file
2
What do these letters mean?
PMHNP-BC — Psychiatric-Mental Health Nurse Practitioner, Board Certified
A board-certified psychiatric nurse practitioner.

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Practice location Address checks out

18715 106th Avenue Ct E
Puyallup, WA 98374-8735
Phone: (206) 759-0207
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence AP61183787 (WA)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence AP132350 (TX)

Record details

NPI number1821530155
Entity typeIndividual (Type 1)
GenderFemale
Credentials PMHNP-BC
Sole proprietorYes
NPI enumeratedNovember 17, 2016
Last updated in NPPESAugust 25, 2022
Certification dateAugust 25, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Mindful Therapy Group Pc — 646 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Puyallup