KYLE C PETRICEK (NPI# 1518571454) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518571454 |
| Entity Type | Individual |
| Full Name | KYLE C PETRICEK |
| Practice Address |
122 16th Ave E Seattle WA 98112-5212 |
| Mailing Address |
6400 Southcenter Blvd Tukwila WA 98188-2547 |
| Practice Telephone | 2063022700 |
| Practice Fax Number | 2063022700 |
| Mailing Telephone | 2069012000 |
| Mailing Fax Number | 2069012010 |
| Enumeration Date | 2020-09-08 |
| Last Update Date | 2020-09-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
122 16TH AVE E |
| City | SEATTLE |
| State | WA |
| Zip Code | 98112-5212 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821042813 | Rowin Elizabeth Cantrell | Psychiatry & Neurology | 122 16th Ave E, Sound Mental Health, Seattle, WA 98112-5212 | 2006-05-22 |
| 1639778210 | Elliott C Noell | Counselor | 122 16th Ave E, Seattle, WA 98112-5212 | 2020-10-23 |
| 1265031850 | Jenny Yi | Counselor | 122 16th Ave E, Seattle, WA 98112-5212 | 2020-10-23 |
| 1003415779 | Matthew L Wald | Counselor | 122 16th Ave E, Seattle, WA 98112-5212 | 2020-10-22 |
| 1952909848 | China R Bolden | Counselor | 122 16th Ave E, Seattle, WA 98112-5212 | 2020-10-13 |
| 1255947594 | Tsz Yan Chan | Counselor | 122 16th Ave E, Seattle, WA 98112-5212 | 2020-09-22 |
| 1801401385 | James Lawler | Counselor | 122 16th Ave E, Seattle, WA 98112-5212 | 2020-09-11 |
| 1932714417 | Mary Zeitler | Counselor | 122 16th Ave E, Seattle, WA 98112-5212 | 2020-09-11 |
| 1821603309 | Anna M Plotkin-swing | Counselor | 122 16th Ave E, Seattle, WA 98112-5212 | 2020-09-11 |
| 1316551294 | Mattie R O'boyle | Counselor | 122 16th Ave E, Seattle, WA 98112-5212 | 2020-09-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891254991 | Justin Jeng-young Fu | Student in an Organized Health Care Education/Training Program | 125 16 Th Ave E, Csb 545, Seattle, WA 98112 | 2019-03-18 |
| 1275015604 | Eyewear Gallery LLC | Optometrist | 3121 E. Madison St Ste 102, Seattle, WA 98112 | 2018-09-01 |
| 1336637081 | Oh Plastic and Reconstructive Surgery LLC | Plastic Surgery | 602 27th Ave E, Seattle, WA 98112 | 2018-04-27 |
| 1992228191 | John Joseph Folta | Chiropractor | 3121 E Madison St Ste 103a, Seattle, WA 98112 | 2017-07-19 |
| 1083161061 | Sheick Toure | Counselor | 122 16 Ave E, Seattle, WA 98112 | 2016-09-07 |
| 1457721805 | Jessica Donovan | Audiologist | 201 16th Ave E # Cmb, Seattle, WA 98112 | 2015-09-29 |
| 1952777427 | Ronald Berenson | Physiological Laboratory | 2032 41st Avenue, Seattle, WA 98112 | 2015-08-19 |
| 1225419005 | Adrienne Foley | Counselor | 1833 40th Ave. E., Seattle, WA 98112 | 2015-06-17 |
| 1952721771 | Ling Guo | Internal Medicine | Kaiser Permanente Central Hospital Building, 126 16th Ave E, Seattle, WA 98112 | 2014-04-19 |
| 1134548068 | Anne Gayman | Family Medicine | 125 16th Avenue East, Csb-540, Group Health Family Medicine Residency, Seattle, WA 98112 | 2014-04-08 |
| Find all providers in zip 98112 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396342358 | Emma Peconga | Student in an Organized Health Care Education/Training Program | 3619 Ashworth Ave N, Seattle, WA 98103-8116 | 2020-10-02 |
| 1780290361 | Compassionate Peer Counseling LLC | Student in an Organized Health Care Education/Training Program | 3250 Airport Way S Ste 608, Seattle, WA 98134-2172 | 2020-09-19 |
| 1336751684 | Binabahen Shah | Student in an Organized Health Care Education/Training Program | 6035 4th Ave Nw, Seattle, WA 98107-2109 | 2020-08-18 |
| 1316558968 | Jimmy Nguyen | Student in an Organized Health Care Education/Training Program | 5525 23rd Ave S, Seattle, WA 98108-2918 | 2020-08-16 |
| 1174133672 | Selomie Habtemichael | Student in an Organized Health Care Education/Training Program | 10000 30th Ave Sw, Seattle, WA 98146-3720 | 2020-08-09 |
| 1659980720 | Joseph Banham | Student in an Organized Health Care Education/Training Program | 12057 Lakeside Pl Ne, Seattle, WA 98125-5956 | 2020-07-24 |
| 1326662396 | Dale Justin Podolsky | Student in an Organized Health Care Education/Training Program | 4800 Sand Point Way Ne, Ob.9.520, Seattle Children's, Seattle, WA 98105 | 2020-06-04 |
| 1659993723 | Caroline Mullins | Student in an Organized Health Care Education/Training Program | 701 N 36th St Ste 3000, Seattle, WA 98103-8868 | 2020-05-12 |
| 1730700741 | Christian Van Rooyen | Student in an Organized Health Care Education/Training Program | 1951 Pacific Street, Seattle, WA 98195 | 2020-04-30 |
| 1669092128 | Ahmed Abdelrazek | Student in an Organized Health Care Education/Training Program | 1959 Ne Pacific Street, 356560, Department of Psychiart, Seattle, WA 98195-6560 | 2020-04-24 |
| Find all providers in SEATTLE | ||||
Please comment or provide details below to improve the information on KYLE C PETRICEK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.