Active NPI
Jeffrey S. Tebbs, DNP, PHD
- Psychiatric/Mental Health Nurse Practitioner
- Olympia, WA
National Provider Identifier
1114181989
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- AP60045999
- Practice address
- 525 Columbia St NW Ste 202
Olympia, WA 98501-1098 - Phone
- (360) 878-9312
- Fax
- (360) 878-9887
- NPI assigned
- Jul 10, 2008
- Last updated
- Oct 2, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 11996960-4405 | UT | |
| Adult Psychiatric/Mental Health Registered Nurse | 163WP0809X | RN00164186 | WA | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | AP60045999 | WA | Primary |
Addresses
Primary practice location
525 Columbia St NW Ste 202
Olympia, WA 98501-1098
Mailing address
525 Columbia St NW Ste 202
Olympia, WA 98501-1098
Phone (360) 878-9312
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN00164186 | WA | MD | Adult Psychiatric/Mental Health Registered Nurse |
| 11996960-4405 | UT | MD | Psychiatric/Mental Health Nurse Practitioner |
| AP60045999 | WA | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727827200000",
"number": "1114181989",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "525 COLUMBIA ST NW STE 202",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985011098",
"telephone_number": "360-878-9312"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "525 COLUMBIA ST NW STE 202",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985011098",
"telephone_number": "360-878-9312",
"fax_number": "360-878-9887"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TEBBS",
"first_name": "JEFFREY",
"middle_name": "S.",
"name_prefix": "Dr.",
"credential": "DNP, PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-07-10",
"last_updated": "2024-10-02",
"certification_date": "2024-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "UT",
"license": "11996960-4405",
"primary": false
},
{
"code": "163WP0809X",
"taxonomy_group": "",
"desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
"state": "WA",
"license": "RN00164186",
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "WA",
"license": "AP60045999",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Olympia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.