Kimberly Samuelson, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

61570680 Issued in WA

Practice address

9909 168TH St E Ste 102
Puyallup, WA 98375-2513

Phone

(253) 445-3000

NPI assigned

Feb 21, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kimberly Huckleby Former name

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

Group practices

Nordquist Integrated MedicineGroup PAC ID 9234596156, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Nordquist Integrated Medicine

  • Integrative Medicine Physician
  • Puyallup, WA
  • NPI 1033838750

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1740096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740268800000",
    "number": "1396541124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9909 168TH ST E STE 102",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983752513",
            "telephone_number": "253-445-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9909 168TH ST E STE 102",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983752513",
            "telephone_number": "253-445-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUELSON",
        "first_name": "KIMBERLY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-21",
        "last_updated": "2025-02-23",
        "certification_date": "2025-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "61570680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "HUCKLEBY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ashley Salontay, PHARMD
• Roberta Louise Salveson, CPNP
• Sammy B D Pak DDS PLLC
• Sammy Ingham Speech Therapy, LLC
• Kelly Jean Samson
• Camille Samujh, DO
• Torrey Michelle Sanbeck
• Imani Mari Sanchez
• Mary Sanchez
• Jennifer Ward Sanders, LMHCA, RN, CCC-SLP

• Nurse Practitioner in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2025; 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.