Individual provider Active NPI

Julie A Lesko, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Issaquah, WA
National Provider Identifier
1871820985
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
60706003 Issued in WA
Practice address
3707 Providence Point Dr SE Ste G
Issaquah, WA 98029-6216
Phone
(425) 390-5402
Fax
(425) 375-7360
NPI assigned
Nov 10, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN33983 NV
Family Nurse Practitioner 363LF0000X APN0001415 NV
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 60706003 WA Primary

Addresses

Primary practice location

3707 Providence Point Dr SE Ste G
Issaquah, WA 98029-6216

Mailing address

22211 SE 42ND LN
Issaquah, WA 98029-7215
Phone (425) 390-5402

Other identifiers 5

IdentifierTypeStateIssuer
2012015653OtherAMERICAN NURSE CREDENTIALING CENTER
0001415OtherNVAPRN
60706003OtherWAAPRN
2016004217OtherAMERICAN NURSE CREDENTIALING CENTER
RN33983OtherNVREGISTERED NURSE

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN33983NVMDRegistered Nurse
APN0001415NVMDFamily Nurse Practitioner
60706003WAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Optimum Mental Health Services, LLC Psychiatric/Mental Health Past Accepting new patients
Eastside TMS X Wellness Center Psychiatric/Mental Health 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": "1257811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1871820985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22211 SE 42ND LN",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980297215",
            "telephone_number": "425-390-5402",
            "fax_number": "425-375-7360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3707 PROVIDENCE POINT DR SE STE G",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980296216",
            "telephone_number": "425-390-5402",
            "fax_number": "425-375-7360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESKO",
        "first_name": "JULIE",
        "middle_name": "A",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-10",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NV",
            "license": "RN33983",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "APN0001415",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "60706003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN NURSE CREDENTIALING CENTER",
            "identifier": "2012015653",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN",
            "identifier": "0001415",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN",
            "identifier": "60706003",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN NURSE CREDENTIALING CENTER",
            "identifier": "2016004217",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE",
            "identifier": "RN33983",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Issaquah, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2020; 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.