Active NPI
Kimberly S. Lindell, PA
- Physician Assistant
- Medical Lake, WA
National Provider Identifier
1295095255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA60280792
- Practice address
- 850 Maple Street
Eastern State Hospital
Medical Lake, WA 99022-0800 - Phone
- (509) 565-4000
- Fax
- (509) 565-4203
- NPI assigned
- May 24, 2012
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA60280792 | WA | Primary |
Addresses
Primary practice location
850 Maple Street
Eastern State Hospital
Medical Lake, WA 99022-0800
Mailing address
PO Box 800
Eastern State Hospital
Medical Lake, WA 99022-0800
Phone (509) 565-4000
Other names 1
- Kimberly S Palanuik
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eastern State Hospital Pharmacy | Past | Accepting new patients | |
| Department of Social | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Psychiatric Hospital
- Medical Lake, WA
- NPI 1467440602
-
- Psychiatric Hospital
- Tacoma, WA
- NPI 1144295080
-
- Long Term Care Pharmacy
- Medical Lake, WA
- NPI 1679651970
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1337817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463529600000",
"number": "1295095255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 800",
"address_2": "EASTERN STATE HOSPITAL",
"city": "MEDICAL LAKE",
"state": "WA",
"postal_code": "990220800",
"telephone_number": "509-565-4000",
"fax_number": "509-565-4705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "850 MAPLE STREET",
"address_2": "EASTERN STATE HOSPITAL",
"city": "MEDICAL LAKE",
"state": "WA",
"postal_code": "990220800",
"telephone_number": "509-565-4000",
"fax_number": "509-565-4203"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LINDELL",
"first_name": "KIMBERLY",
"middle_name": "S.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-05-24",
"last_updated": "2016-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WA",
"license": "PA60280792",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KIMBERLY",
"last_name": "PALANUIK",
"middle_name": "S",
"credential": "PA-C",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Medical Lake, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2016; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.