Colleen Koorn, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP61192894 Issued in WA

Practice address

1716 W Marine View Dr Ste C
Everett, WA 98201-2098

Phone

(425) 259-0212

NPI assigned

May 15, 2022

Last updated

May 15, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Colleen Mack Former name

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Seva Medical PLLCGroup PAC ID 0547621708, 28 clinicians

Providence Health and Services- WashingtonGroup PAC ID 8325100480, 527 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Regional Medical Center Everett Hospital, Everett, WA, CCN 500014

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Providence Health & Services- Washington

  dba PMG NW Wa

  • General Practice Physician
  • Everett, WA
  • NPI 1124270715
  Medicare reassignment Care Compare group NPD
• Seva Medical, PLLC

  • Internal Medicine Physician
  • Bellevue, WA
  • NPI 1679264014
  Medicare reassignment Care Compare group NPD
• Providence Health & Services-Washington

  dba PMG NW WA Cardiovascular and Thoracic Surgery

  • Surgery Physician
  • Everett, WA
  • NPI 1114236791
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Providence Health & Services-Wa

  dba Providence Regional Medical Center Everett

  • Hospitalist Physician
  • Everett, WA
  • NPI 1649615220
  Care Compare affiliation
• Providence Health & Services-Wa

  • General Acute Care Hospital
  • Everett, WA
  • NPI 1700037801
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1652572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652572800000",
    "number": "1023755774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12719 47TH DR NE",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982718634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1716 W MARINE VIEW DR STE C",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982012098",
            "telephone_number": "425-259-0212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOORN",
        "first_name": "COLLEEN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-15",
        "last_updated": "2022-05-15",
        "certification_date": "2022-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61192894",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON STATE DEPARTMENT OF HEALTH",
            "identifier": "AP61192894",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN ACADEMY OF NURSE PRACTITIONERS CERTIFICATION BOARD",
            "identifier": "F06211752",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COLLEEN",
            "last_name": "MACK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ajitha Kommalapati, MD
• Tracy Kondracki
• Mariama L Konteh
• Kenny P Koo, M.D.
• Donald A Koontz, D.D.S.
• Julia M Kopcak, PA-C
• Janae Kopet
• Felmas Adhiambo Koranga
• Jaye Michelle Koropp, BA,, PEER COUNSELOR
• Kimberly Koski, AUD

• Family Nurse Practitioner in Everett, WA
• Providers in Everett, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.