Trina Koudelka, CNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

AP60807103 Issued in WA

Practice address

3015 Squalicum Pkwy Ste 100
Bellingham, WA 98225-1906

Phone

(360) 715-4186

Fax

(360) 715-4187

NPI assigned

Sep 21, 2016

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

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

{
    "created_epoch": "1474416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521158400000",
    "number": "1497203244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 SE 164TH AVE DEPT 358",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986838004",
            "telephone_number": "360-729-1462",
            "fax_number": "360-729-3104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 SQUALICUM PKWY STE 100",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251906",
            "telephone_number": "360-715-4186",
            "fax_number": "360-715-4187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUDELKA",
        "first_name": "TRINA",
        "name_prefix": "Ms.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-21",
        "last_updated": "2018-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WA",
            "license": "AP60807103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kara Kosco, DPT, PT
• Rita A Kostelik, ARNP
• Amber Kostial
• Brenda Kay Kotewa, LPC, NCC, LMHC
• Julia Rose Kotewa
• Patrick Douglas Kounovsky
• Svetlana Kovalenko
• Kowals Pediatrics, PS
• Stephanie L Kraft
• Olivia C Kramm, MSN, RN

• Gerontology Nurse Practitioner in Bellingham, WA
• Providers in Bellingham, WA by specialty
• Gerontology Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2018; 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.