Julia Kornyushin-Anderson, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW61151368 Issued in WA

Practice address

2905 NE 2ND Ave
Camas, WA 98607-2310

Phone

(360) 772-5066

NPI assigned

Nov 3, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Peacehealth

  • General Acute Care Hospital
  • Vancouver, WA
  • NPI 1134178999

  WA

  Medicare reassignment NPD
• Peacehealth

  • Cardiovascular Disease Physician
  • Vancouver, WA
  • NPI 1003194911
  NPD

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

{
    "created_epoch": "1635897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1942965058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2905 NE 2ND AVE",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986072310",
            "telephone_number": "360-772-5066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2905 NE 2ND AVE",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986072310",
            "telephone_number": "360-772-5066"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8716 E Mill Plain Blvd",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986642531",
            "country_code": "US",
            "telephone_number": "360-696-5300",
            "fax_number": "360-729-3372",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KORNYUSHIN-ANDERSON",
        "first_name": "JULIA",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-03",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171R00000X",
            "taxonomy_group": "",
            "desc": "Interpreter",
            "state": "WA",
            "license": "6509",
            "primary": false
        },
        {
            "code": "171R00000X",
            "taxonomy_group": "",
            "desc": "Interpreter",
            "state": "WA",
            "license": "8182",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61151368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kind Care Dentistry
• Landon George King, D.D.S.
• Maria Joanne Kintz, LMP
• John Koehler, MD
• Jean Ann Koncos, LMP
• Irina Koval
• Anna P Kramareva, LMP
• Lacamas Counseling LLC
• Lacamas Creek SNF Healthcare LLC
• Lacamas Medical Group PC

• All providers in Camas, WA
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.