Active NPI
Kimberle Jeanne Ykema
- Social Worker
- Port Angeles, WA
National Provider Identifier
1548762644
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- LW60816188
- Practice address
- 933 E 1St St
Port Angeles, WA 98362-4012 - Phone
- (360) 452-7891
- Fax
- (360) 452-8087
- NPI assigned
- Mar 5, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LW60816188 | WA | |
| Social Worker | 104100000X | LW60816188 | WA | Primary |
Addresses
Primary practice location
933 E 1St St
Port Angeles, WA 98362-4012
Mailing address
933 E 1St St
Port Angeles, WA 98362-4012
Phone (360) 452-7891
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2097082 | Medicaid | WA |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1520208000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698710400000",
"number": "1548762644",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "933 E 1ST ST",
"city": "PORT ANGELES",
"state": "WA",
"postal_code": "983624012",
"telephone_number": "360-452-7891",
"fax_number": "360-452-8087"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "933 E 1ST ST",
"city": "PORT ANGELES",
"state": "WA",
"postal_code": "983624012",
"telephone_number": "360-452-7891",
"fax_number": "360-452-8087"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YKEMA",
"first_name": "KIMBERLE",
"middle_name": "JEANNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-03-05",
"last_updated": "2023-10-31",
"certification_date": "2023-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WA",
"license": "LW60816188",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "WA",
"license": "LW60816188",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2097082",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Port Angeles, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.