Olga Klachkovich

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

PA60608537 Issued in WA

Practice address

100 NE Gilman Blvd
Issaquah, WA 98027-2925

Phone

(425) 557-8000

Fax

(425) 557-8014

NPI assigned

Nov 23, 2014

Last updated

Apr 16, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Virginia Mason Medical CenterGroup PAC ID 9830002617, 867 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Virginia Mason Medical Center Hospital, Seattle, WA, CCN 500005

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Virginia Mason Medical Center

  • General Acute Care Hospital
  • Seattle, WA
  • NPI 1801851258
  Medicare reassignment Care Compare group
• King County Public Hospital District No 2

  dba Booth Gardner Parkinsons Care Center

  • Neuromusculoskeletal Medicine & OMM Physician
  • Kirkland, WA
  • NPI 1801986070
  Medicare reassignment
• King County Public Hospital District No 2

  dba EvergreenHealth Medical Group Pro Fees

  • Internal Medicine Physician
  • Kirkland, WA
  • NPI 1467542639
  NPD
• King County Public Hospital District No. 2

  dba EvergreenHealth at Home Physical Therapy

  • Physical Therapist
  • Kirkland, WA
  • NPI 1356920946
  NPD
• Virginia Mason Medical Center

  dba Virginia Mason Medical Center-Neurosurgery

  • Neurological Surgery Physician
  • Seattle, WA
  • NPI 1487701991
  NPD
• Virginia Mason Medical Center

  dba St Joseph Medical Center

  • Interventional Cardiology Physician
  • Tacoma, WA
  • NPI 1821711953
  NPD

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

• Virginia Mason Medical Center

  • General Acute Care Hospital
  • Seattle, WA
  • NPI 1801851258
  Care Compare affiliation

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

{
    "created_epoch": "1416700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523836800000",
    "number": "1548667330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 9TH AVE",
            "address_2": "M4-PFS",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981012756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NE GILMAN BLVD",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272925",
            "telephone_number": "425-557-8000",
            "fax_number": "425-557-8014"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4311 11th Ave NE",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981056366",
            "country_code": "US",
            "telephone_number": "206-616-4001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLACHKOVICH",
        "first_name": "OLGA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-23",
        "last_updated": "2018-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WA",
            "license": "PA60608537",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William B Kirshner, MD
• Celina Kisielewski, LMT
• Anasztazia Szofia Rosaleen Kiss
• Michael Kitsis, DMD
• Kathryn Corinne Kitzing, CP60324554; MC608611
• Kevin Timothy Klar, LMHC
• Leah Klauer
• Kleaca Dialysis LLC (Issaquah Dialysis)
• Denis Kleiman
• Nika Kleiman

• Neurology Physician in Issaquah, WA
• Providers in Issaquah, WA by specialty
• Neurology Physician in Washington

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