NPIMap

Individual provider Active NPI

Katie Elise Clarkson, MSN, ARNP, BC

  • Family Nurse Practitioner
  • Aberdeen, WA
National Provider Identifier
1497927297
Registry record updated Jul 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP0092 Issued in GU
Practice address
1020 Anderson Drive
Suite 203
Aberdeen, WA 98520
Phone
(360) 533-6063
Fax
(360) 533-2204
NPI assigned
Apr 1, 2008
Last updated
Jul 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP0092 GU Primary
Registered Nurse 163W00000X RE1368 GU

Addresses

Primary practice location

1020 Anderson Drive
Suite 203
Aberdeen, WA 98520

Mailing address

1020 Anderson Drive
Suite 203
Aberdeen, WA 98520
Phone (360) 533-6063

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110113001164 WA Practitioner - Nurse Practitioner 2163611625 Reassigns benefits to 1 organization
Practice locations: Aberdeen, WA
I20250507003504 TX Practitioner - Nurse Practitioner 2163611625 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Quinault Indian NationGroup PAC ID 4385164839, 14 clinicians

Practice addresses (Care Compare)

1020 Anderson Dr
Suite 203
Aberdeen, WA 98520-1055
Phone (360) 533-6063

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RE1368GUMDRegistered Nurse
NP0092GUMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sea Mar Community Health Centers Family CurrentSince Nov 9, 2010 Accepting new patients
Fisher Family Medicine, PS Current Accepting new patients
Juliette Erickson MD PS Current Accepting new patients
Sea Mar Community Health Centers Family Current Accepting new patients
Herdel Medical Services Current Accepting new patients
Sea Mar Community Health Centers Registered Nurse CurrentSince Nov 9, 2010 Accepting new patients
Quinault Indian Nation CurrentSince Jan 25, 2025 Accepting new patients

Locations

1020 Anderson Dr
Ste 203
Aberdeen, WA 98520
Phone (360) 533-6063

1813 Sumner Ave
Aberdeen, WA 98520
Phone (360) 538-1293

421 W State St
Aberdeen, WA 98520

3030 Limited Ln NW
Olympia, WA 98502
Phone (360) 352-6000

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1207008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1497927297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 ANDERSON DRIVE",
            "address_2": "SUITE 203",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "98520",
            "telephone_number": "360-533-6063",
            "fax_number": "360-533-2204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 ANDERSON DRIVE",
            "address_2": "SUITE 203",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "98520",
            "telephone_number": "360-533-6063",
            "fax_number": "360-533-2204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKSON",
        "first_name": "KATIE",
        "middle_name": "ELISE",
        "credential": "MSN, ARNP, BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-01",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GU",
            "license": "NP0092",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GU",
            "license": "RE1368",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aberdeen, WA

Sources for this page

Verify at the official NPI Registry.