KYLE JOSEPH MICON (NPI# 1952827776) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952827776 |
| Entity Type | Individual |
| Full Name | KYLE JOSEPH MICON |
| Practice Address |
607 Se Everett Mall Way Everett WA 98208-3248 |
| Mailing Address |
14515 N Creek Dr Apt A307 Mill Creek WA 98012-5767 |
| Practice Telephone | 4252657000 |
| Mailing Telephone | 7167993541 |
| Enumeration Date | 2017-08-15 |
| Last Update Date | 2017-08-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | AP60763393 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
607 SE EVERETT MALL WAY |
| City | EVERETT |
| State | WA |
| Zip Code | 98208-3248 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104940642 | Kim Leufroy | Specialist | 607 Se Everett Mall Way, Plaza Suites 10-7, Everett, WA 98208-3248 | 2007-03-19 |
| 1518402346 | Alexander M Huelskamp | Physician Assistant | 607 Se Everett Mall Way, Everett, WA 98208-3248 | 2017-01-03 |
| 1972980266 | Grace Hillstrand | Physical Therapy Assistant | 607 Se Everett Mall Way, #6b, Everett, WA 98208-3248 | 2015-05-06 |
| 1053798389 | Stefanie Schultz | Physical Therapy Assistant | 607 Se Everett Mall Way, Suite 6b, Everett, WA 98208-3248 | 2015-05-06 |
| 1144565219 | Drx Wa Urgent Care Providers, Pllc | Clinic/Center | 607 Se Everett Mall Way, Suite 2, Everett, WA 98208-3248 | 2012-11-30 |
| 1902168461 | Immediate Clinic Seattle, Inc | Clinic/Center | 607 Se Everett Mall Way, Suite 2, Everett, WA 98208-3248 | 2012-06-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790270296 | Kenneth Britt Dyer | Registered Nurse | 10333 19th Ave, Se, Ste #109, Everett, WA 98208 | 2018-06-27 |
| 1518482215 | Glacier Peak Healthcare, Inc. | Home Health | 10530 19th Ave Se Ste 201, Everett, WA 98208 | 2017-08-03 |
| 1114454865 | Aliza Kreisman | Registered Nurse | 11020 19th Avenue Se, Kaiser Permanente of Washington Seattle Care Clinic, Everett, WA 98208 | 2017-05-12 |
| 1902269418 | Clay Eakin | Counselor | 2732 Grand Evenue, Everett, WA 98208 | 2016-04-01 |
| 1467810259 | Elizabeth Anne Powley | Marriage & Family Therapist | 1920 100th Street Southeast, Bld C3, Everett, WA 98208 | 2016-02-08 |
| 1659745842 | Andrea Rose Bedlington | Pharmacist | 11407 33rd Dr. Se, Everett, WA 98208 | 2015-11-25 |
| 1396123865 | Sound Surgeons Pllc | Clinic/Center | 125 130th Street Se, 1st Floor, Everett, WA 98208 | 2015-05-15 |
| 1831576537 | Chris Sturgeon | Counselor | 10102 Meridian Ave, Everett, WA 98208 | 2015-05-01 |
| 1982011128 | James M Lee | Physical Therapist | 10821 19th Ave Se Ste 102, Everett, WA 98208 | 2014-07-21 |
| 1972937357 | Ronald Tracy | Dentist | 10315 19th Avenue Se Suite 110, Everett, WA 98208 | 2013-08-21 |
| Find all providers in zip 98208 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851933642 | Julia Kase | Nurse Practitioner | 728 134th St Sw Ste 207, Everett, WA 98204-5322 | 2019-10-13 |
| 1740765650 | Joan W Kamata | Nurse Practitioner | 38 Carter St Apt 313, Everett, MA 02149-2525 | 2018-09-26 |
| 1679092704 | Bethell Assefa | Nurse Practitioner | 3624 Colby Ave Ste B, Everett, WA 98201-4789 | 2017-09-09 |
| 1518011089 | Susan Farist Butler | Nurse Practitioner | Tri City Mhc, 173 Chelsea St, Everett, MA 02149 | 2007-01-22 |
| 1780643973 | Jessica Susan Webb | Nurse Practitioner | 12728 19th Ave Se, Suite 300, Everett, WA 98208-6526 | 2006-03-17 |
| 1063499168 | Tracy J Wilbraham | Nurse Practitioner | 173 Chelsea St, Everett, MA 02149-4632 | 2005-12-29 |
| 1912518093 | Holly Anne Bernstein | Nurse Practitioner | 3927 Rucker Ave, Everett, WA 98201-4833 | 2020-08-12 |
| 1073124491 | Alana Brianne Beck | Nurse Practitioner | 1818 121st St Se, Everett, WA 98208-5985 | 2020-08-10 |
| 1588273114 | Dayna Wong | Nurse Practitioner | 1818 121st St Se, Everett, WA 98208-5985 | 2020-07-29 |
| 1063021137 | Katelyn Pedersen | Nurse Practitioner | 3927 Rucker Ave, Everett, WA 98201-4833 | 2020-07-24 |
| Find all providers in EVERETT | ||||
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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.