KELLY LUNDBERG (NPI# 1639670656) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639670656 |
| Entity Type | Individual |
| Full Name | KELLY LUNDBERG |
| Credential | FNP |
| Practice Address |
11203 Bridgeport Way Sw Lakewood WA 98499-3002 |
| Practice Telephone | 2535891380 |
| Enumeration Date | 2018-02-25 |
| Last Update Date | 2018-03-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
60833349 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538638788 | Kelly Rippy Lundberg | Speech-Language Pathologist | 304 S Main St, Saint John, WA 99171-8772 | 2018-11-16 |
| 1669562278 | Kelly Joan Lundberg | Psychologist | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2006-10-13 |
| Street Address |
11203 BRIDGEPORT WAY SW |
| City | LAKEWOOD |
| State | WA |
| Zip Code | 98499-3002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386627545 | Kristi Kay Mckinney | Allergy & Immunology | 11203 Bridgeport Way Sw, Lakewood, WA 98499 | 2005-11-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275159592 | Sea Mar Community Health Centers | Clinic/Center | 5700 100th Street Se, Suite 510, Lakewood, WA 98499 | 2020-06-23 |
| 1568018828 | Heather Leigh Andrade | Behavioral Analyst | 6210 75th St W Ste 100, Lakewood, WA 98499 | 2019-08-13 |
| 1043870876 | Seoul Chinese Herbs Inc | Acupuncturist | 8705 S. Tacoma Way, Lakewood, WA 98499 | 2019-06-14 |
| 1013572064 | Puget Sound Kidney Centers | Clinic/Center | 11950 47th Ave Sw, Lakewood, WA 98499 | 2019-05-06 |
| 1447736657 | Marcela Cunan | Counselor | 9330 59th Avenue Southest, Lakewood, WA 98499 | 2018-07-11 |
| 1609382381 | Leroy Moore IIi | Counselor | 8811 S. Tacoma Way, 106, Lakewood, WA 98499 | 2017-12-18 |
| 1578077657 | Andrea Gaston | Behavior Technician | 8815 S. Tacoma Way, Suite 122, Lakewood, WA 98499 | 2017-11-27 |
| 1609389931 | Jennifer King | Social Worker | 5900 100th St Sw Ste 17b, Lakewood, WA 98499 | 2017-11-08 |
| 1750806337 | Wonyoung Lee | Counselor | 8811 South Tacoma Way, Suite 106, Lakewood, WA 98499 | 2017-08-04 |
| 1043749443 | Frederick Paltron Edwards | Counselor | 9500 Front Street, Suite 100, Lakewood, WA 98499 | 2017-06-08 |
| Find all providers in zip 98499 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982218574 | Primary Health Services LLC | Nurse Practitioner | 500 River Ave Ste 200, Lakewood, NJ 08701-4719 | 2020-09-01 |
| 1235748237 | Esther Steinhaus | Nurse Practitioner | 409 Ashley Ave, Lakewood, NJ 08701-4866 | 2020-07-26 |
| 1609402817 | Bridgit V Wedgle | Nurse Practitioner | 2556 S Jellison Ct, Lakewood, CO 80227-2872 | 2020-03-19 |
| 1255963187 | Tresa Marie Glaser | Nurse Practitioner | 8807 25th Ave S, Lakewood, WA 98499-8301 | 2020-02-08 |
| 1972149490 | Richard Allan Coronel Sy | Nurse Practitioner | 11645 Walcroft St, Lakewood, CA 90715-1356 | 2019-11-19 |
| 1609411867 | Jennifer Lynn Wondel | Nurse Practitioner | 10424 W Arkansas Dr, Lakewood, CO 80232-5014 | 2019-11-12 |
| 1457901555 | Nancy Wairimu Minjire | Nurse Practitioner | 9537 Gravelly Lake Dr Sw # E10, Lakewood, WA 98499-1513 | 2019-09-19 |
| 1619432325 | Soroh Neuberger | Nurse Practitioner | 232 Jamescrest Ct, Lakewood, NJ 08701-4708 | 2019-02-06 |
| 1487118782 | Krista Leigh Petry | Nurse Practitioner | 4720 Baker St, Lakewood, NY 14750-9772 | 2019-01-31 |
| 1649740093 | Svetlana Polyakova | Nurse Practitioner | 8316 W Eastman Pl, Lakewood, CO 80227-6240 | 2018-11-28 |
| Find all providers in LAKEWOOD | ||||
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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.