Elena V Khorosheva-Brown, LPN, GEM-STONE THERA

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LP60440752 Issued in WA

Practice address

330 Rollingwood Dr
Kelso, WA 98626-9756

Phone

(503) 442-8826

NPI assigned

Aug 26, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1629936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1396412334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 ROLLINGWOOD DR",
            "city": "KELSO",
            "state": "WA",
            "postal_code": "986269756",
            "telephone_number": "503-442-8826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 ROLLINGWOOD DR",
            "city": "KELSO",
            "state": "WA",
            "postal_code": "986269756",
            "telephone_number": "503-442-8826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOROSHEVA-BROWN",
        "first_name": "ELENA",
        "middle_name": "V",
        "credential": "LPN, GEM-STONE THERA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-26",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Licensed Practical Nurse",
            "state": "WA",
            "license": "LP60440752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelso Al, LLC
• Kelso Drug Co
• Kelso School District
• Colleen M Kennedy
• Paul Travis Kern, CDAC
• Danny Barton Kilgore, LPN
• Brandy Kmetz
• Elena Koleva
• Zachariah Kramer, M.D.
• Shannon Dwayne Kretz, AA, CDPT

• Licensed Practical Nurse in Kelso, WA
• Providers in Kelso, WA by specialty
• Licensed Practical Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 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.