Active NPI
Andrea Lynn Kormondy, LMP
- Specialist
- Seattle, WA
National Provider Identifier
1982858486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MA17831
- Practice address
- 110 Lakeside Ave
Suite 1
Seattle, WA 98122-6594 - Phone
- (206) 322-5118
- NPI assigned
- Nov 11, 2008
- 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 | MA17831 | WA | Primary |
Addresses
Primary practice location
110 Lakeside Ave
Suite 1
Seattle, WA 98122-6594
Mailing address
309 16TH Ave E. #301
Seattle, WA 98112
Phone (206) 234-9973
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 |
|---|---|---|---|
| MA17831 | WA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1226361600000",
"number": "1982858486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "309 16TH AVE E. #301",
"city": "SEATTLE",
"state": "WA",
"postal_code": "98112",
"telephone_number": "206-234-9973"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 LAKESIDE AVE",
"address_2": "SUITE 1",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981226594",
"telephone_number": "206-322-5118"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KORMONDY",
"first_name": "ANDREA",
"middle_name": "LYNN",
"credential": "LMP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-11-11",
"last_updated": "2008-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WA",
"license": "MA17831",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.