COPESTONE PSYCHIATRIC, LLC (NPI# 1609477538) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609477538 |
| Entity Type | Organization |
| Organization Name | COPESTONE PSYCHIATRIC, LLC |
| Practice Address |
11335 Ne 122nd Way Ste 105 Kirkland WA 98034-6933 |
| Mailing Address |
224 Thompson St Pmb 218 Hendersonville NC 28792-2806 |
| Practice Telephone | 8283939025 |
| Mailing Telephone | 8283939025 |
| Enumeration Date | 2020-11-06 |
| Last Update Date | 2020-11-06 |
| Authorized Official Name | WARREN SHADKO (OWNER) |
| Authorized Official Telephone | 8283939025 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | COPESTONE PSYCHIATRIC, LLC | 11335 Ne 122nd Way Ste 105, Kirkland, WA 98034-6933 |
| Street Address |
11335 NE 122ND WAY STE 105 |
| City | KIRKLAND |
| State | WA |
| Zip Code | 98034-6933 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003231218 | Shellie Respess | Counselor | 11335 Ne 122nd Way Ste 105, Kirkland, WA 98034-6933 | 2014-02-25 |
| 1982226353 | Emily Greene-hartsfield | Naturopath | 11335 Ne 122nd Way Ste 105, Kirkland, WA 98034-6933 | 2020-05-08 |
| 1164079968 | Jennifer Lake | Counselor | 11335 Ne 122nd Way Ste 105, Kirkland, WA 98034-6933 | 2019-08-26 |
| 1184285272 | Alex Lee Engen | Chiropractor | 11335 Ne 122nd Way Ste 105, Kirkland, WA 98034-6933 | 2019-06-28 |
| 1962964460 | Maria Coronado Rebolledo | Behavior Technician | 11335 Ne 122nd Way Ste 105, Kirkland, WA 98034-6933 | 2019-04-03 |
| 1841752755 | Lindsey Grimm | Behavior Technician | 11335 Ne 122nd Way Ste 105, Kirkland, WA 98034-6933 | 2019-04-01 |
| 1437610797 | Talia Keller | Behavior Technician | 11335 Ne 122nd Way Ste 105, Kirkland, WA 98034-6933 | 2019-03-28 |
| 1013487925 | Salute Nutrition, Pllc | Nutritionist | 11335 Ne 122nd Way Ste 105, Kirkland, WA 98034-6933 | 2018-12-04 |
| 1134517261 | Flow Psychology Pllc | Psychologist | 11335 Ne 122nd Way Ste 105, Kirkland, WA 98034-6933 | 2014-12-23 |
| 1407250079 | Clairemarie Clark | Psychologist | 11335 Ne 122nd Way Ste 105, Kirkland, WA 98034-6933 | 2014-10-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578116596 | Rachel Bowers | Behavior Technician | 1335 Northeast 122nd Way, Suite 105, Kirkland, WA 98034 | 2019-07-18 |
| 1740841048 | Kristina Louise Inghram | Behavior Technician | 11415 Ne 128th St., Suite 40, Kirkland, WA 98034 | 2019-06-26 |
| 1053978064 | Matthew A. Bagnulo, Dds, Ps | Dentist | 11830 Ne 128th St., #202, Kirkland, WA 98034 | 2019-05-24 |
| 1629568928 | Stephanie Michalko | Optometrist | 11800 Ne 128th St Ste 110, Kirkland, WA 98034 | 2018-05-14 |
| 1952800013 | Heath Family Counseling LLC | Marriage & Family Therapist | 12025 115th Ave. Ne, Building D, Ste 200, Kirkland, WA 98034 | 2018-02-05 |
| 1891202834 | Barbara Josephine Gorham | Counselor | 2025 115th Ave Ne, Bldg D, #200, Kirkland, WA 98034 | 2017-12-29 |
| 1548782915 | Eleanor Hollis Wall | Counselor | 14340 102nd Ave Ne, Kirkland, WA 98034 | 2017-07-07 |
| 1457885212 | Peter Schoonmaker | Hospitalist | 12040 Ne 128th Street, Ms105, Kirkland, WA 98034 | 2017-04-18 |
| 1780124370 | Rebecca Managan | Advanced Practice Midwife | 12303 Ne 130th Ln Ste Coral225, Kirkland, WA 98034 | 2017-03-01 |
| 1669821104 | Winter Gonzalez | Counselor | 11720 97th Ln Ne Apt A411, Kirkland, WA 98034 | 2016-06-06 |
| Find all providers in zip 98034 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619376530 | Leilani De Jong | Nurse Practitioner | 5400 Carillon Pt Fl 4, Kirkland, WA 98033-7357 | 2014-08-15 |
| 1194898528 | Patricia Roth Wuertzer | Nurse Practitioner | 11411 Ne 124th St Ste 190, Kirkland, WA 98034-4318 | 2006-11-15 |
| 1710599758 | Kelly Knickerbocker Arnp Pllc | Nurse Practitioner | 11411 Ne 124th St Ste 190, Kirkland, WA 98034-4318 | 2020-08-20 |
| 1689224727 | Patricia Duenas Morgan | Nurse Practitioner | 12040 Ne 128th St, Kirkland, WA 98034-3013 | 2019-09-19 |
| 1902333644 | Ewa Kazimiera Kozlowska | Nurse Practitioner | 10200 Ne 132nd St, Kirkland, WA 98034 | 2017-05-12 |
| 1619403698 | Antonina Kozlowska | Nurse Practitioner | 10200 Ne 132nd St, Kirkland, WA 98034-2831 | 2017-05-11 |
| 1427304138 | Kelly Marie Knickerbocker | Nurse Practitioner | 11411 Ne 124th St, Suite 190, Kirkland, WA 98034-4314 | 2012-07-31 |
| 1124337969 | Amy O. Zachara | Nurse Practitioner | 10200 Ne 132nd St, Kirkland, WA 98034-2831 | 2010-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134720139 | Youwen Hu | Nurse Practitioner | 10824 Se 170th St Unit A304, Renton, WA 98055-5950 | 2020-11-05 |
| 1831799048 | Sarah Louise Weerheim | Nurse Practitioner | 2727 Hollycroft St Ste 110v, Gig Harbor, WA 98335-1371 | 2020-10-27 |
| 1619576774 | Bethany Heath Arnp-pmhnp Pllc | Nurse Practitioner | 1224 West Riverside, Apt 408, Spokane, WA 99201 | 2020-10-20 |
| 1437761988 | Hollye Hahn | Nurse Practitioner | 1012 Nw Longview Dr, Oak Harbor, WA 98277-8947 | 2020-08-17 |
| 1386254290 | Candie M. Wellwood | Nurse Practitioner | 9908 S Sherman Rd, Spokane, WA 99224-9811 | 2020-08-05 |
| 1104434679 | Progressive Psychiatric Consultant | Nurse Practitioner | 170 S Lincoln St # 150, Spokane, WA 99201-4443 | 2020-07-21 |
| 1235747213 | Peaceful Coexistence, LLC | Nurse Practitioner | 4730 University Way Ne Ste 104, Seattle, WA 98105-4424 | 2020-07-16 |
| 1134747066 | New Dawn Psychotherapy Pllc | Nurse Practitioner | 2223 Benson Rd S Apt D102, Renton, WA 98055-8837 | 2020-07-07 |
| 1376160861 | Clarity Behavioral Health | Nurse Practitioner | 7704 193rd Pl Sw, Edmonds, WA 98026-6234 | 2020-06-30 |
| 1174140677 | Rachael Davison | Nurse Practitioner | 22525 Se 64th Pl Ste 228, Issaquah, WA 98027-5383 | 2020-06-30 |
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| 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.