Active NPI
Jennifer Beattie
- Athletic Trainer
- Pullman, WA
National Provider Identifier
1003445255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 1360 Cougar Way
Pullman, WA 99163 - Phone
- (360) 801-6024
- NPI assigned
- Apr 8, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Primary |
Addresses
Primary practice location
1360 Cougar Way
Pullman, WA 99163
Mailing address
PO Box 372
Belfair, WA 98528-0372
Phone (360) 801-6024
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 029-676-02 | Other | WA | KAISER PERMANENTE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586304000000",
"number": "1003445255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 372",
"city": "BELFAIR",
"state": "WA",
"postal_code": "985280372",
"telephone_number": "360-801-6024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1360 COUGAR WAY",
"city": "PULLMAN",
"state": "WA",
"postal_code": "99163",
"telephone_number": "360-801-6024"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEATTIE",
"first_name": "JENNIFER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-04-08",
"last_updated": "2020-04-08",
"certification_date": "2020-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KAISER PERMANENTE",
"identifier": "029-676-02",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pullman, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.