Active NPI
Ilene Terese Krenelka, LMP, LE
- Specialist
- Lakewood, WA
National Provider Identifier
1467588905
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 10948
- Practice address
- 6302 93Rd St SW
Lakewood, WA 98499-9222 - Phone
- (253) 678-9692
- NPI assigned
- Feb 26, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 10948 | WA | Primary |
Addresses
Primary practice location
6302 93Rd St SW
Lakewood, WA 98499-9222
Mailing address
6302 93Rd St SW
Lakewood, WA 98499-9222
Phone (253) 678-9692
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10948 | WA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458086400000",
"number": "1467588905",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6302 93RD ST SW",
"city": "LAKEWOOD",
"state": "WA",
"postal_code": "984999222",
"telephone_number": "253-678-9692"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6302 93RD ST SW",
"city": "LAKEWOOD",
"state": "WA",
"postal_code": "984999222",
"telephone_number": "253-678-9692"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRENELKA",
"first_name": "ILENE",
"middle_name": "TERESE",
"name_prefix": "Ms.",
"credential": "LMP, LE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-26",
"last_updated": "2016-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WA",
"license": "10948",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakewood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.