Individual provider Active NPI

Kathleen E Tucholke, F.N.P.

  • Family Nurse Practitioner
  • Selah, WA
National Provider Identifier
1659529345
Registry record updated Mar 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP60400436 Issued in WA
Practice address
620 N Park Dr
Selah, WA 98942-4100
Phone
(509) 697-5511
Fax
(509) 225-2707
NPI assigned
Sep 5, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2016

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 209007234 IL
Family Nurse Practitioner 363LF0000X AP60400436 WA Primary

Addresses

Primary practice location

620 N Park Dr
Selah, WA 98942-4100

Mailing address

3800 Summitview Ave
Yakima, WA 98902-2715
Phone (509) 248-7849

Other identifiers 1

IdentifierTypeStateIssuer
2008004581OtherILANCC CERTIFICATION

Other names 1

  • Kathleen E Yong Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20131106000607 WA Practitioner - Nurse Practitioner 0547338014 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209007234ILMDFamily Nurse Practitioner
AP60400436WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kittitas County Public Hospital Dist 1 Current Accepting new patients
Kittitas County Public Hosp Dist 1 CurrentSince Nov 3, 2021 Accepting new patients
Kittitas County Public Hospital Dist 1 CurrentSince Nov 3, 2021 Accepting new patients
Kittitas County Public Hospital Dist 1 Past Accepting new patients

Locations

100 E Jackson Ave
Ellensburg, WA 98926
Phone (509) 574-6000

603 S Chestnut St
Ellensburg, WA 98926
Phone (509) 933-8693

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1220572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458604800000",
    "number": "1659529345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 SUMMITVIEW AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989022715",
            "telephone_number": "509-248-7849",
            "fax_number": "509-225-2707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 N PARK DR",
            "city": "SELAH",
            "state": "WA",
            "postal_code": "989424100",
            "telephone_number": "509-697-5511",
            "fax_number": "509-225-2707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCHOLKE",
        "first_name": "KATHLEEN",
        "middle_name": "E",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-05",
        "last_updated": "2016-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209007234",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60400436",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANCC CERTIFICATION",
            "identifier": "2008004581",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "YONG",
            "middle_name": "E",
            "credential": "F.N,P",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Selah, WA

Sources for this page

Verify at the official NPI Registry.