Karen M Carlson, ARNP
Individual provider Active NPI Nurse Practitioner · Tenino, WA
NPI 1245317486 · NPPES record last updated May 3, 2021
Key facts
- NPI
- 1245317486
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- AP30004220 (WA)
- Practice address
- 273 Sussex Ave E
Tenino, WA 98589-9359 - Phone
- (360) 264-5665
- Fax
- (360) 264-5666
- NPI assigned
- Nov 1, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Jamestown S'Klallam Tribe
Practice addresses (Care Compare)
808 N 5TH Ave
Sequim, WA 98382-3045
Phone (360) 683-5900
Hospital & facility affiliations
- Olympic Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20091027000263 | WA | Practitioner - Nurse Practitioner | 9931246865 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP30004220 | WA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jamestown S'Klallam Tribe | Current |
Accepting new patients | |
| Jamestown S'Klallam Tribe | Current |
Accepting new patients | |
| Jamestown S'Klallam Tribe | Current |
Accepting new patients | |
| Jamestown S'Klallam Tribe | Current | Accepting new patients |
Locations
808 N 5th Ave
Sequim, WA 98382
Phone (360) 582-4840
526 S 9th Ave
Sequim, WA 98382
Phone (360) 681-7755
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | AP30004220 | WA | Yes |
Addresses
Primary practice location
273 Sussex Ave E
Tenino, WA 98589-9359
Mailing address
PO Box 3360
Portland, OR 97208-3360
Phone (360) 413-4200
Other practice location 1
2555 Marvin Rd NE
Lacey, WA 98516-3138
Phone (360) 413-4200
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9635285 | Medicaid | WA |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kcarlson100664@wm.providencedirect.org | Direct |
Other providers in Tenino, WA
- Mary Dawn Adams
- Ashley Dental LLC
- Candice Rebecca Baughman
- Janet Lynn Black
- Jennifer L. Booker
- Tianne Carolyn Carrigan
- Daniel Ray Coleman
- Ronald H Coulson
- Daniel R. Coleman
- Samantha Davis
All providers in Tenino, WA · Nurse Practitioner in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 3, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.