Active NPI
Yoo-Jin J Ko
- Nurse Practitioner
- Bothell, WA
National Provider Identifier
1225463516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- AP60408809
- Practice address
- 24016 Bothell Everett Hwy Unit 100
Bothell, WA 98021-9361 - Phone
- (425) 529-6333
- NPI assigned
- Sep 5, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | AP60408809 | WA | Primary |
Addresses
Primary practice location
24016 Bothell Everett Hwy Unit 100
Bothell, WA 98021-9361
Mailing address
PO Box 5127
Everett, WA 98206-5127
Phone (425) 258-3900
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225463516 | Medicaid | WA | |
| 2033045 | Medicaid | WA |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1378339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706140800000",
"number": "1225463516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5127",
"city": "EVERETT",
"state": "WA",
"postal_code": "982065127",
"telephone_number": "425-258-3900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24016 BOTHELL EVERETT HWY UNIT 100",
"city": "BOTHELL",
"state": "WA",
"postal_code": "980219361",
"telephone_number": "425-529-6333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KO",
"first_name": "YOO-JIN",
"middle_name": "J",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-09-05",
"last_updated": "2024-01-25",
"certification_date": "2024-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WA",
"license": "AP60408809",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1225463516",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2033045",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bothell, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.