Individual provider Active NPI

Patricia Noel Kreger, LSWAIC

  • Clinical Social Worker
  • Everett, WA
National Provider Identifier
1306217559
Registry record updated Nov 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SC61094692 Issued in WA
Practice address
9930 Evergreen Way Ste Z154
Everett, WA 98204-3889
Phone
(253) 334-7443
NPI assigned
Oct 14, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Clinical Social Worker 1041C0700X SC61094692 WA Primary

Addresses

Primary practice location

9930 Evergreen Way Ste Z154
Everett, WA 98204-3889

Mailing address

9930 Evergreen Way Ste Z154
Everett, WA 98204-3889
Phone (253) 334-7443

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

State licenses

LicenseStateTypeSpecialty
SC61094692WAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1444780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637539200000",
    "number": "1306217559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9930 EVERGREEN WAY STE Z154",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982043889",
            "telephone_number": "253-334-7443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9930 EVERGREEN WAY STE Z154",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982043889",
            "telephone_number": "253-334-7443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREGER",
        "first_name": "PATRICIA",
        "middle_name": "NOEL",
        "credential": "LSWAIC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-14",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "SC61094692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2021; 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.