Active NPI
Julie Kristen Korssjoen, LMP
- Specialist
- North Bend, WA
National Provider Identifier
1871862284
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MA60258944
- Practice address
- 13710 461St PL SE
North Bend, WA 98045-8865 - Phone
- (425) 888-0460
- NPI assigned
- Dec 14, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MA60258944 | WA | Primary |
Addresses
Primary practice location
13710 461St PL SE
North Bend, WA 98045-8865
Mailing address
13710 461St PL SE
North Bend, WA 98045-8865
Phone (425) 888-0460
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
| License | State | Type | Specialty |
|---|---|---|---|
| MA60258944 | WA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323820800000",
"number": "1871862284",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13710 461ST PL SE",
"city": "NORTH BEND",
"state": "WA",
"postal_code": "980458865",
"telephone_number": "425-888-0460"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13710 461ST PL SE",
"city": "NORTH BEND",
"state": "WA",
"postal_code": "980458865",
"telephone_number": "425-888-0460"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KORSSJOEN",
"first_name": "JULIE",
"middle_name": "KRISTEN",
"credential": "LMP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-12-14",
"last_updated": "2011-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WA",
"license": "MA60258944",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Bend, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.