Jennifer Rose Tininenko, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY60129683 Issued in WA

Practice address

1200 5TH Ave
Suite 800
Seattle, WA 98101-3132

Phone

(206) 374-0109

Fax

(206) 374-0108

NPI assigned

Dec 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Jennifer Rose Tininenko Rarity Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 1, 2016 through Jan 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277942400000",
    "number": "1104994888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 5TH AVE",
            "address_2": "SUITE 800",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981013132",
            "telephone_number": "206-374-0109",
            "fax_number": "206-374-0108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 5TH AVE",
            "address_2": "SUITE 800",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981013132",
            "telephone_number": "206-374-0109",
            "fax_number": "206-374-0108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TININENKO",
        "first_name": "JENNIFER",
        "middle_name": "ROSE",
        "name_prefix": "Ms.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2010-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY60129683",
            "primary": true
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "WA",
            "license": "PY60129683",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "WA",
            "license": "PY60129683",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY60129683",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "TININENKO RARITY",
            "middle_name": "ROSE",
            "credential": "PHD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kristofor Tingelstad, MHP, LMHCA
• Lance Tingey
• Leigha Tingey, PA-C
• Ellis Robert Tingstad, LMP
• Quynh Thu Tinh, PT
• Jodi Lee Tinkel, MD
• Karin Marie Tinta-Guibert, MACP CLASS OF 2020
• Sikirat I Tinubu-Karch, MD
• Carl Allen Tippins, PH.D. LMHC
• Rhonda K Tipps, LMP

• Clinical Psychologist in Seattle, WA
• Providers in Seattle, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2010; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.