Individual provider Active NPI

Chaya Joie Kudla, LAC, LMP

  • Acupuncturist
  • Leavenworth, WA
National Provider Identifier
1679769103
Registry record updated Sep 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC00002858 Issued in WA
Practice address
10171 Chumstick Hwy
Suite a
Leavenworth, WA 98826-9267
Phone
(509) 782-0448
NPI assigned
Sep 18, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC00002858 WA Primary

Addresses

Primary practice location

10171 Chumstick Hwy
Suite a
Leavenworth, WA 98826-9267

Mailing address

227 Bellevue Way NE
438
Bellevue, WA 98004-5721
Phone (425) 454-2380

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AC00002858WAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1190073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190073600000",
    "number": "1679769103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 BELLEVUE WAY NE",
            "address_2": "438",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980045721",
            "telephone_number": "425-454-2380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10171 CHUMSTICK HWY",
            "address_2": "SUITE A",
            "city": "LEAVENWORTH",
            "state": "WA",
            "postal_code": "988269267",
            "telephone_number": "509-782-0448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUDLA",
        "first_name": "CHAYA",
        "middle_name": "JOIE",
        "name_prefix": "Ms.",
        "credential": "LAC, LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-18",
        "last_updated": "2007-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "WA",
            "license": "AC00002858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leavenworth, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.