Individual provider Active NPI

Katherine Amanda Ko, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Bellevue, WA
National Provider Identifier
1891927000
Registry record updated Oct 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP60213651 Issued in WA
Practice address
2105 112TH Ave NE Ste 201
Bellevue, WA 98004-2945
Phone
(425) 968-5948
Fax
(425) 385-0985
NPI assigned
Aug 20, 2009
Last updated
Oct 29, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP60213651 WA Primary

Addresses

Primary practice location

2105 112TH Ave NE Ste 201
Bellevue, WA 98004-2945

Mailing address

2105 112TH Ave NE Ste 201
Bellevue, WA 98004-2945
Phone (425) 968-5948

Other practice location 1

4205 148th Ave NE
Suite 103
Bellevue, WA 98007-7114
Phone (425) 968-5948

Other names 1

  • Katherine Amanda Powell Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jan 9, 2025 through Jan 9, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AP60213651WAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Moore, Arnp, PLLC Psychiatric/Mental Health Past Accepting new patients
Eastside Play Therapy 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1250726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572307200000",
    "number": "1891927000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 112TH AVE NE STE 201",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980042945",
            "telephone_number": "425-968-5948",
            "fax_number": "425-385-0985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 112TH AVE NE STE 201",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980042945",
            "telephone_number": "425-968-5948",
            "fax_number": "425-385-0985"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4205 148th Ave NE",
            "address_2": "Suite 103",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "WA",
            "postal_code": "980077114",
            "country_code": "US",
            "telephone_number": "425-968-5948",
            "fax_number": "425-658-3392",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KO",
        "first_name": "KATHERINE",
        "middle_name": "AMANDA",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-20",
        "last_updated": "2019-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP60213651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "POWELL",
            "middle_name": "AMANDA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.