Individual provider Active NPI

Jennifer Hayse

  • Marriage & Family Therapist
  • Mill Creek, WA
National Provider Identifier
1104603042
Registry record updated Sep 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFTA.MG.61474970 Issued in WA
Practice address
16000 Bothell Everett Hwy Ste 360
Mill Creek, WA 98012-1577
Phone
(425) 357-9111
NPI assigned
Sep 13, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFTA.MG.61474970 WA Primary

Addresses

Primary practice location

16000 Bothell Everett Hwy Ste 360
Mill Creek, WA 98012-1577

Mailing address

4415 Corliss Ave N
Seattle, WA 98103-7656
Phone (650) 644-6184

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

State licenses

LicenseStateTypeSpecialty
MFTA.MG.61474970WAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mill Creek Family Services, PLLC PastSince Sep 17, 2023 Accepting new patients

Organizations & group practices 1

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": "1694563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1104603042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4415 CORLISS AVE N",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981037656",
            "telephone_number": "650-644-6184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16000 BOTHELL EVERETT HWY STE 360",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980121577",
            "telephone_number": "425-357-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYSE",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-13",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "MFTA.MG.61474970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mill Creek, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.