Kristen Marie Kicinski

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP61494885 Issued in WA

Practice address

200 Lilly Rd NE Ste C
Olympia, WA 98506-5080

Phone

(360) 918-8336

NPI assigned

Mar 9, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Northwest Resources IIGroup PAC ID 3678842788, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Northwest Resources II

  • Addiction (Substance Use Disorder) Counselor
  • Olympia, WA
  • NPI 1164586210
  Medicare reassignment Care Compare group
• Northwest Resources II

  • Addiction (Substance Use Disorder) Counselor
  • Shelton, WA
  • NPI 1770647778

  Psychiatric/Mental Health

  NPD (past)

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

{
    "created_epoch": "1678320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709251200000",
    "number": "1356041032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 LILLY RD NE STE C",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065080",
            "telephone_number": "360-918-8336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 LILLY RD NE STE C",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065080",
            "telephone_number": "360-918-8336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KICINSKI",
        "first_name": "KRISTEN",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-09",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61494885",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60662619",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Khai Lam DC
• Adi K Khalsa, RBT
• Jasan Khangura
• Suchit Khanijao, MD
• Shayar Patrick Kian, MD
• Craig Kidd, CNIM
• Tyler Kier, LMP LICENSE
• Denise Joy Kiers
• Joshua S Kievitt, DC
• Brandi Kight

• Psychiatric/Mental Health Nurse Practitioner in Olympia, WA
• Providers in Olympia, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.