Kory Matthew Simonsen, DNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP61462517 Issued in WA

Practice address

10904 167TH Ave NE
Redmond, WA 98052-2752

Phone

(425) 220-3394

Fax

(425) 242-3115

NPI assigned

Jun 22, 2022

Sex

Male

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": "1655856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1417688136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10904 167TH AVE NE",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980522752",
            "telephone_number": "425-220-3394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10904 167TH AVE NE",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980522752",
            "telephone_number": "425-220-3394",
            "fax_number": "425-242-3115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONSEN",
        "first_name": "KORY",
        "middle_name": "MATTHEW",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-22",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61462517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judith A. Simmons, OTR
• Bridgett Simon, N.D.
• Daniel Simon, LICSWA
• Barbara Simonowitz, M.D.
• David Alan Simonowitz, MD
• Lacey Sindelar, PT/L
• William H Singer, PH.D.
• Kit A Singh, DDS
• Shreya Sheetla Singh, PT
• Ashna Sinha

• Psychiatric/Mental Health Nurse Practitioner in Redmond, WA
• Providers in Redmond, 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 Oct 17, 2024; 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.