Amy Katherine Quaresma, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW61299599 Issued in WA

Practice address

2139 Van Giesen St
Richland, WA 99354-2746

Phone

(509) 946-4645

Fax

(509) 946-1398

NPI assigned

Mar 8, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Seattle, WA
  • NPI 1396810701
  Medicare reassignment NPD
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Renton, WA
  • NPI 1124264577
  NPD
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Everett, WA
  • NPI 1386935351
  NPD

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

{
    "created_epoch": "1299542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1629376140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2139 VAN GIESEN ST",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993542746",
            "telephone_number": "509-946-4645",
            "fax_number": "509-946-1398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2139 VAN GIESEN ST",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993542746",
            "telephone_number": "509-946-4645",
            "fax_number": "509-946-1398"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2120 Exchange St Ste 301",
            "address_purpose": "LOCATION",
            "city": "Astoria",
            "state": "OR",
            "postal_code": "971033364",
            "country_code": "US",
            "telephone_number": "503-325-0241",
            "fax_number": "503-861-2043",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 SW 27th St",
            "address_purpose": "LOCATION",
            "city": "Renton",
            "state": "WA",
            "postal_code": "980572603",
            "country_code": "US",
            "telephone_number": "425-235-2800",
            "fax_number": "425-235-2815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUARESMA",
        "first_name": "AMY",
        "middle_name": "KATHERINE",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-08",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60450483",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61299599",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2043567",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1200 SW 27th St",
            "city": "Renton",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980572603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christopher Brandon Putrzenski, LMT
• Charlotte Pyles-Reiten, OTR/L
• Alyson C Pyles, CCC-SLP
• Marwan Qattan, M.D.
• Wei Qiu, MD
• Queensgate Family Chiropractic PLLC
• Amanda Quesnell, CG
• Joel Quiroz, PA-C
• Farhan Qureshi, MD
• R & B Fleck Enterprises, LLC

• Clinical Social Worker in Richland, WA
• Providers in Richland, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.