Active NPI
Jennifer Bolnick, M.D.
- Family Medicine Physician
- Seattle, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD00027849
- Practice address
- 904 7TH Ave
Seattle, WA 98104 - Phone
- (206) 860-5404
- Fax
- (206) 860-2295
- NPI assigned
- Jan 31, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | MD00027849 | WA | |
| Family Medicine Physician | 207Q00000X | MD00027849 | WA | Primary |
Addresses
Primary practice location
904 7TH Ave
Seattle, WA 98104
Mailing address
PO Box 34584
Seattle, WA 98124-1584
Phone (509) 241-7349
Other practice location 1
200 15th Ave E
Seattle, WA 98112-5260
Phone (206) 326-3000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8133613 | Medicaid | WA |
Medicare participation
Medicare enrollment files- 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: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00027849 | WA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of Washington | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of Washington | Family Medicine | Current | Accepting new patients |
| Kaiser Foundation Health Plan of Washington | Current | Accepting new patients |
Locations
14701 179th Ave SE
Monroe, WA 98272
Phone (360) 794-1409
19379 7th Ave NE
Poulsbo, WA 98370
Phone (360) 394-1000
200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530
9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800
Organizations & group practices 3
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.
-
- Multi-Specialty Clinic/Center
- Seattle, WA
- NPI 1396810701
-
- Multi-Specialty Clinic/Center
- Renton, WA
- NPI 1124264577
Family Medicine
-
- Multi-Specialty Clinic/Center
- Everett, WA
- NPI 1386935351
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1527724800000",
"number": "1073650693",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 34584",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981241584",
"telephone_number": "509-241-7349",
"fax_number": "509-241-7316"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "904 7TH AVE",
"city": "SEATTLE",
"state": "WA",
"postal_code": "98104",
"telephone_number": "206-860-5404",
"fax_number": "206-860-2295"
}
],
"practiceLocations": [
{
"address_1": "200 15th Ave E",
"address_purpose": "LOCATION",
"city": "Seattle",
"state": "WA",
"postal_code": "981125260",
"country_code": "US",
"telephone_number": "206-326-3000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BOLNICK",
"first_name": "JENNIFER",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-31",
"last_updated": "2018-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "WA",
"license": "MD00027849",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "MD00027849",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8133613",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2018; 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.