Jacquelyn Rose Murillo, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

60866630 Issued in WA

Practice address

25742 104TH Ave SE
Kent, WA 98030-7691

Phone

(206) 263-0540

NPI assigned

Dec 1, 2008

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Jacquelyn Martin Former name

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jquetal240258@direct.ochin.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• King County Finance

  • Multi-Specialty Clinic/Center
  • Seattle, WA
  • NPI 1306903604
  Medicare reassignment NPD
• King County Finance

  • Federally Qualified Health Center (FQHC)
  • Seattle, WA
  • NPI 1518593904
  NPD
• Seattle King Co Dept of Public Health

  • Federally Qualified Health Center (FQHC)
  • Seattle, WA
  • NPI 1780876284
  NPD (past)
• Northwest Urology, LLC

  • Specialist
  • Portland, OR
  • NPI 1629461397
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1228089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1003061292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 SW OAK ST",
            "address_2": "STE.210",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972041817",
            "telephone_number": "503-988-3663",
            "fax_number": "503-988-3015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25742 104TH AVE SE",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980307691",
            "telephone_number": "206-263-0540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURILLO",
        "first_name": "JACQUELYN",
        "middle_name": "ROSE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-01",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "60866630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELYN",
            "last_name": "MARTIN",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Elizabeth Mungai-Ivory
• Eric H Munson, CPP
• Bushra Muqabel
• Ayat Murad
• Jayme Murakami
• Michael Mwangi Murimi
• Lisa Murphy
• Michelle Murphy, LMP
• Alisa Lynn Murray, PH.D., E-R.Y.T.
• Kavya Lakshmi Murthi

• Nurse Practitioner in Kent, WA
• Providers in Kent, WA by specialty
• Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.