Active NPI
Harley Wren Kinyon, CCC-A
- Audiologist
- Silverdale, WA
National Provider Identifier
1093762692
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- CD000025516
- Practice address
- 2200 NW Myhre Rd
Silverdale, WA 98383-7681 - Phone
- (360) 830-1100
- NPI assigned
- May 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist-Hearing Aid Fitter | 237600000X | CD00002516 | WA | |
| Audiologist | 231H00000X | CD000025516 | WA | Primary |
Addresses
Primary practice location
2200 NW Myhre Rd
Silverdale, WA 98383-7681
Mailing address
9621 Ridgetop Blvd NW
Silverdale, WA 98383-8502
Phone (360) 830-1204
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 640004426 | Other | RAILROAD MEDICARE | |
| 7108947 | Medicaid | WA | |
| 9052556 | Medicaid | WA | |
| 158357 | Other | WA | LABOR & INDUSTRIES |
| 7927357 | Other | AETNA | |
| 8918KI | Other | REGENCE BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CD000025516 | WA | MD | Audiologist |
| CD00002516 | WA | MD | Audiologist-Hearing Aid Fitter |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148774400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1520380800000",
"number": "1093762692",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9621 RIDGETOP BLVD NW",
"city": "SILVERDALE",
"state": "WA",
"postal_code": "983838502",
"telephone_number": "360-830-1204"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 NW MYHRE RD",
"city": "SILVERDALE",
"state": "WA",
"postal_code": "983837681",
"telephone_number": "360-830-1100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KINYON",
"first_name": "HARLEY",
"middle_name": "WREN",
"credential": "CCC-A",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-28",
"last_updated": "2018-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "237600000X",
"taxonomy_group": "",
"desc": "Audiologist-Hearing Aid Fitter",
"state": "WA",
"license": "CD00002516",
"primary": false
},
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "WA",
"license": "CD000025516",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "640004426",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7108947",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9052556",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR & INDUSTRIES",
"identifier": "158357",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7927357",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUE SHIELD",
"identifier": "8918KI",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Silverdale, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.