Active NPI
Connie E Jensen, CRNA
- Certified Registered Nurse Anesthetist
- Tacoma, WA
National Provider Identifier
1104874908
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- AP30005224
- Practice address
- 502 S M St
Suite 200
Tacoma, WA 98405-3728 - Phone
- (253) 475-5433
- Fax
- (253) 473-6715
- NPI assigned
- May 4, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | AP30005224 | WA | Primary |
Addresses
Primary practice location
502 S M St
Suite 200
Tacoma, WA 98405-3728
Mailing address
PO Box 97115
Lakewood, WA 98497-0115
Phone (253) 588-7911
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AP30005224 | Other | WA | MEDICAL LICENSE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP30005224 | WA | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Valley Anesthesia Associates, PLLC | Past | Accepting new patients | |
| Sports and Spine | Past | Accepting new patients |
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.
-
- Clinic/Center
- Bellevue, WA
- NPI 1598255903
-
- Anesthesiology Physician
- Renton, WA
- NPI 1033165097
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1301443200000",
"number": "1104874908",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 97115",
"city": "LAKEWOOD",
"state": "WA",
"postal_code": "984970115",
"telephone_number": "253-588-7911",
"fax_number": "253-984-6774"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "502 S M ST",
"address_2": "SUITE 200",
"city": "TACOMA",
"state": "WA",
"postal_code": "984053728",
"telephone_number": "253-475-5433",
"fax_number": "253-473-6715"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENSEN",
"first_name": "CONNIE",
"middle_name": "E",
"credential": "CRNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-05-04",
"last_updated": "2011-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "WA",
"license": "AP30005224",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "AP30005224",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.