Jacqueline Warui Kimani, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP61510073 Issued in WA

Practice address

38036 39TH Ave S # NA
Auburn, WA 98001-8784

Phone

(253) 266-8212

NPI assigned

Nov 22, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mindful Therapy Group PCGroup PAC ID 4981872561, 654 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Mindful Therapy Group PC

  • Clinical Social Worker
  • Mountlake Terrace, WA
  • NPI 1316238678

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Navos

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Seattle, WA
  • NPI 1194728105
  NPD (past)

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

{
    "created_epoch": "1669075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720051200000",
    "number": "1043929581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38036 39TH AVE S",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980018784",
            "telephone_number": "253-266-8212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38036 39TH AVE S # NA",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980018784",
            "telephone_number": "253-266-8212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMANI",
        "first_name": "JACQUELINE",
        "middle_name": "WARUI",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-22",
        "last_updated": "2024-07-04",
        "certification_date": "2024-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60349857",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61510073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Hyuk Kim
• Joanne Kim
• Michael C Kim, DDS
• So-Yoon Kim
• Sonia Catherine Kim, SUDP
• Peter Kimani
• Elizaphan Kimuya
• Suzette Kincaid
• Kevin King
• Lora King, LMFTA

• Psychiatric/Mental Health Nurse Practitioner in Auburn, WA
• Providers in Auburn, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.