Individual provider Active NPI

Lauren Amelia Poulson, RN

  • Registered Nurse
  • Bellevue, WA
National Provider Identifier
1205641677
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
61478001 Issued in WA
Practice address
3805 108TH Ave NE Ste 204
Bellevue, WA 98004-7613
Phone
(425) 242-1713
NPI assigned
Feb 11, 2025
Last updated
Feb 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 61478001 WA Primary

Addresses

Primary practice location

3805 108TH Ave NE Ste 204
Bellevue, WA 98004-7613

Mailing address

39555 SE Park St Apt 207
Snoqualmie, WA 98065-9517

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
61478001WAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Ikron Greater Seattle PastSince Feb 23, 2025 Accepting new patients
Ikron Greater Seattle PastSince Feb 23, 2025 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1739232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1205641677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39555 SE PARK ST APT 207",
            "city": "SNOQUALMIE",
            "state": "WA",
            "postal_code": "980659517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3805 108TH AVE NE STE 204",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980047613",
            "telephone_number": "425-242-1713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POULSON",
        "first_name": "LAUREN",
        "middle_name": "AMELIA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-11",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "61478001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.