Active NPI
Jennifer Lynn Nicholas, FNP
- Nurse Practitioner
- Clarkston, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- ARNP.AP.60299874-NP
- Practice address
- 1433 5TH St
Clarkston, WA 99403-2714 - Phone
- (509) 758-5141
- Fax
- (509) 758-5299
- NPI assigned
- Jun 26, 2012
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | ARNP.AP.60299874-NP | WA | Primary |
Addresses
Primary practice location
1433 5TH St
Clarkston, WA 99403-2714
Mailing address
4700 Exchange CT Ste 110
Boca Raton, FL 33431-4450
Phone (561) 948-0291
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1250 SE Bishop Blvd
Suite F
Pullman, WA 99163-5449
Phone (509) 758-5141
Merit-based Incentive Payment System (MIPS)
- Final score
- 89.65 of 100
- Quality
- 79.3
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Integrated Dermatology of Clarkston PLLC | Current | Accepting new patients |
Locations
4700 Exchange Ct
Ste 110
Boca Raton, FL 33431
Phone (561) 223-8081
1433 5th St
#C
Clarkston, WA 99403
Phone (509) 758-5141
1433 5th St
Clarkston, WA 99403
Phone (509) 758-5141
1250 SE Bishop Blvd
Ste F
Pullman, WA 99163
Phone (509) 332-7424
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.
-
- Dermatology Physician
- Clarkston, WA
- NPI 1609656222
-
- Dermatology Physician
- Clarkston, WA
- NPI 1841269248
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785715200000",
"number": "1083978837",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4700 EXCHANGE CT STE 110",
"city": "BOCA RATON",
"state": "FL",
"postal_code": "334314450",
"telephone_number": "561-948-0291",
"fax_number": "561-859-0429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1433 5TH ST",
"city": "CLARKSTON",
"state": "WA",
"postal_code": "994032714",
"telephone_number": "509-758-5141",
"fax_number": "509-758-5299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLAS",
"first_name": "JENNIFER",
"middle_name": "LYNN",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-26",
"last_updated": "2026-08-03",
"certification_date": "2026-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WA",
"license": "ARNP.AP.60299874-NP",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Clarkston, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2026; 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.