Individual provider Active NPI

Lois Yuran Gore, LICSW

  • Clinical Social Worker
  • Kirkland, WA
National Provider Identifier
1902097900
Registry record updated Oct 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW00006089 Issued in WA
Practice address
515 Kirkland Way
Kirkland, WA 98033-6219
Phone
(206) 240-1742
Fax
(425) 880-4010
NPI assigned
Aug 5, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LW00006089 WA Primary

Addresses

Primary practice location

515 Kirkland Way
Kirkland, WA 98033-6219

Mailing address

515 Kirkland Way
Kirkland, WA 98033-6219
Phone (425) 880-4600

Other identifiers 1

IdentifierTypeStateIssuer
598395OtherWAPREMERA BLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100817000824 WA Practitioner - Clinical Social Worker 0547394231 Practice locations: Seattle, WA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

831 31St Ave S
Seattle, WA 98144-3210
Phone (206) 240-1742

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506816000000",
    "number": "1902097900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 KIRKLAND WAY",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980336219",
            "telephone_number": "425-880-4600",
            "fax_number": "425-880-4010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 KIRKLAND WAY",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980336219",
            "telephone_number": "206-240-1742",
            "fax_number": "425-880-4010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORE",
        "first_name": "LOIS",
        "middle_name": "YURAN",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-05",
        "last_updated": "2017-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW00006089",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREMERA BLUE CROSS",
            "identifier": "598395",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

Verify at the official NPI Registry.