Paul Kwon, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY-202538 Issued in ID

Practice address

422 17TH St
Lewiston, ID 83501-2526

Phone

(208) 743-4680

Fax

(208) 743-1756

NPI assigned

Sep 10, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Dr. Kracke and Associates P a

  • Mental Health Counselor
  • Lewiston, ID
  • NPI 1851448781
  NPD (past)

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

{
    "created_epoch": "1284076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284076800000",
    "number": "1861709990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2145",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835011465",
            "telephone_number": "208-743-4680",
            "fax_number": "208-743-1756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 17TH ST",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835012526",
            "telephone_number": "208-743-4680",
            "fax_number": "208-743-1756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWON",
        "first_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-10",
        "last_updated": "2010-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "ID",
            "license": "PSY-202538",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY 00002290",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806177700",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristy Anne Kuehfuss, PH.D.
• Ajith J Kumar, MD
• John Stephen Kundrat, MD PA
• Suriya Subashini Kunnukutty Mohan
• Gerald Thomas Kurdy, LMSW
• Kym Orthopedics PLLC
• Christie Kytonen, LPN
• Laennec Inpatient Services
• Erica Lafrenier, LMT
• Daniel Stephen Lambert, PA

• Psychologist in Lewiston, ID
• Providers in Lewiston, ID by specialty
• Psychologist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2010; 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.