Individual provider Active NPI

Youngoak Kim Pryor, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Poulsbo, WA
National Provider Identifier
1306934047
Registry record updated Jun 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP30003525 Issued in WA
Practice address
20174 Front Street NE
Poulsbo, WA 98370
Phone
(360) 697-1141
Fax
(360) 697-2395
NPI assigned
Oct 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP30003525 WA Primary

Addresses

Primary practice location

20174 Front Street NE
Poulsbo, WA 98370

Mailing address

PO Box 1611
Poulsbo, WA 98370
Phone (360) 697-1141

Other practice location 1

2830 N Swan Rd Ste 140
Tucson, AZ 85712-6301
Phone (360) 697-1141

Other identifiers 1

IdentifierTypeStateIssuer
96136936MedicaidWA

Other names 1

  • Kim Young-Oak Professional name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120227000663 WA Practitioner - Nurse Practitioner 8325206014 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Front Street Clinic IncGroup PAC ID 5193612935, 8 clinicians

Practice addresses (Care Compare)

20174 Front St NE
Poulsbo, WA 98370-7445
Phone (360) 697-1141

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Front Street Clinic Inc CurrentSince Jan 1, 2001 Accepting new patients
Wandee J. Pryor, Psy.D., LLC Past Accepting new patients

Locations

2830 N Swan Rd
Ste 140
Tucson, AZ 85712
Phone (360) 697-1141

20174 Front St NE
Poulsbo, WA 98370
Phone (360) 626-9034

2819 NW Kitsap Pl
Ste 2B
Silverdale, WA 98383
Phone (360) 689-4964

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750982400000",
    "number": "1306934047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1611",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "98370",
            "telephone_number": "360-697-1141",
            "fax_number": "360-697-2395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20174 FRONT STREET NE",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "98370",
            "telephone_number": "360-697-1141",
            "fax_number": "360-697-2395"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2830 N Swan Rd Ste 140",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857126301",
            "country_code": "US",
            "telephone_number": "360-697-1141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRYOR",
        "first_name": "YOUNGOAK",
        "middle_name": "KIM",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP30003525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "96136936",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIM",
            "last_name": "YOUNG-OAK",
            "credential": "ARNP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Poulsbo, WA

Sources for this page

Verify at the official NPI Registry.