Individual provider Active NPI

Jessica Evelyn Gow-Lee, CNM

  • Advanced Practice Midwife
  • Tamuning, GU
National Provider Identifier
1013134345
Registry record updated Jun 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
100601 Issued in GU
Practice address
472 Chalan San Antonio
Tamuning, GU 96913-3605
Phone
(671) 646-8881
Fax
(671) 648-2548
NPI assigned
Apr 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP60417258 WA
Advanced Practice Midwife 367A00000X 100601 GU Primary
Advanced Practice Midwife 367A00000X AP30002337 WA

Addresses

Primary practice location

472 Chalan San Antonio
Tamuning, GU 96913-3605

Mailing address

388 Ypao Rd
Tamuning, GU 96913-3701
Phone (671) 646-8881

Other practice location 1

515 W Court St
Pasco, WA 99301-3737
Phone (509) 547-2204

Other identifiers 1

IdentifierTypeStateIssuer
1013134345MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GU
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260304003085 GU Practitioner - Certified Nurse Midwife (CNM) 1355666793 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
General Conference Corp of SdaGroup PAC ID 6608777628, 52 clinicians

Practice addresses (Care Compare)

388 Ypao Rd
Tamuning, GU 96913-3701
Phone (671) 646-8881

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP30002337WAMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
General Conference Corp of Sda CurrentSince Feb 18, 2026 Accepting new patients
Tri Cities Community Health Past Accepting new patients

Locations

472 Chalan San Antonio
Tamuning, GU 96913
Phone (671) 646-8881

Interoperability endpoints

  • Direct secure messaging: jessica.gow-lee.1@18826.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782000000000",
    "number": "1013134345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "388 YPAO RD",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969133701",
            "telephone_number": "671-646-8881",
            "fax_number": "671-648-2548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "472 CHALAN SAN ANTONIO",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969133605",
            "telephone_number": "671-646-8881",
            "fax_number": "671-648-2548"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "515 W Court St",
            "address_purpose": "LOCATION",
            "city": "Pasco",
            "state": "WA",
            "postal_code": "993013737",
            "country_code": "US",
            "telephone_number": "509-547-2204",
            "fax_number": "509-545-3960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOW-LEE",
        "first_name": "JESSICA",
        "middle_name": "EVELYN",
        "name_prefix": "Mrs.",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-19",
        "last_updated": "2026-06-21",
        "certification_date": "2026-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60417258",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "GU",
            "license": "100601",
            "primary": true
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "WA",
            "license": "AP30002337",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013134345",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tamuning, GU

Sources for this page

Verify at the official NPI Registry.