Individual provider Active NPI

Joung Evans, ARNP

  • Nurse Practitioner
  • Olympia, WA
National Provider Identifier
1689726317
Registry record updated May 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP30007115 Issued in WA
Practice address
700 Lilly Rd NE
Olympia, WA 98506-5115
Phone
(360) 923-7000
NPI assigned
Jan 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN00068510 WA
Nurse Practitioner 363L00000X AP30007115 WA Primary

Addresses

Primary practice location

700 Lilly Rd NE
Olympia, WA 98506-5115

Mailing address

PO Box 34584
Seattle, WA 98124-1584
Phone (509) 241-7349

Other identifiers 1

IdentifierTypeStateIssuer
9653114MedicaidWA

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
I20070803000095 WA Practitioner - Nurse Practitioner 4587755673 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP30007115WAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington Past Accepting new patients

Organizations & group practices 2

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": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210204800000",
    "number": "1689726317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34584",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241584",
            "telephone_number": "509-241-7349",
            "fax_number": "509-241-7628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 LILLY RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065115",
            "telephone_number": "360-923-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "JOUNG",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2008-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "RN00068510",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP30007115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9653114",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.