Kathy L. Shannon, A.R.N.P.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP30006382 Issued in WA

Practice address

118 E 8TH St
Port Angeles, WA 98362-6129

Phone

(360) 457-0431

Fax

(360) 457-0493

NPI assigned

Oct 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peninsula Behavioral HealthGroup PAC ID 7416845870, 19 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Olympic Medical Center Hospital, Port Angeles, WA, CCN 500072

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/peninsulabehavioral/r4/
• FHIR API: https://api.qualifacts.org/api/fhir/forkshospital/r4/

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.

• Peninsula Behavioral Health

  • Community/Behavioral Health Agency
  • Port Angeles, WA
  • NPI 1760519060
  Medicare reassignment Care Compare group NPD
• North Olympic Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Port Angeles, WA
  • NPI 1154702264
  NPD
• North Olympic Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Port Angeles, WA
  • NPI 1568961969
  NPD
• North Olympic Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Port Angeles, WA
  • NPI 1639036924
  NPD
• Clallam County Public Hospital District No 1

  • Rural Health Clinic/Center
  • Clallam Bay, WA
  • NPI 1235213034
  NPD (past)
• Core Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Longview, WA
  • NPI 1639693781
  NPD (past)
• Quileute Tribal Council

  • Clinic/Center
  • Lapush, WA
  • NPI 1548329105
  NPD (past)
• Radia Inc P S

  • Diagnostic Radiology Physician
  • Lynnwood, WA
  • NPI 1932196607
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Clallam County Public Hospital District 2

  • General Acute Care Hospital
  • Port Angeles, WA
  • NPI 1306845557
  Care Compare affiliation

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1689755811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 E 8TH ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983626129",
            "telephone_number": "360-457-0431",
            "fax_number": "360-457-0493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 E 8TH ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983626129",
            "telephone_number": "360-457-0431",
            "fax_number": "360-457-0493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "KATHY",
        "middle_name": "L.",
        "credential": "A.R.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP30006382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nevaeh Jade Selvidge
• Serenity House of Clallam County
• Harriet G Shafer, ARNP
• Dana Shaltry, DDS, MS
• Mia Shami
• Kimberly Lynn Shannon, M.A., L.M.F.T.
• Jacob Daniel Shapiro, MA-C
• Sara Shapiro, MPH, PT
• Mark Edward Sharp, CDP
• Sharpe Therapy

• Nurse Practitioner in Port Angeles, WA
• Providers in Port Angeles, WA by specialty
• Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.