Individual provider Active NPI

Jennifer Kathleen Croley, LMP

  • Community Health Worker
  • Olympia, WA
National Provider Identifier
1124269360
Registry record updated Mar 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
License
MA 00023965 Issued in WA
Practice address
2407 Washington St SE
Olympia, WA 98501-2960
Phone
(360) 918-6155
NPI assigned
Mar 18, 2009
Last updated
Mar 18, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X MA 00023965 WA Primary

Addresses

Primary practice location

2407 Washington St SE
Olympia, WA 98501-2960

Mailing address

313 5TH Ave SE Ste B
Olympia, WA 98501-1191
Phone (360) 357-6953

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
MA 00023965WAMDCommunity Health Worker

NPI Registry JSON

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

{
    "created_epoch": "1237334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237334400000",
    "number": "1124269360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 5TH AVE SE STE B",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985011191",
            "telephone_number": "360-357-6953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2407 WASHINGTON ST SE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985012960",
            "telephone_number": "360-918-6155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROLEY",
        "first_name": "JENNIFER",
        "middle_name": "KATHLEEN",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-18",
        "last_updated": "2009-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "WA",
            "license": "MA 00023965",
            "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 Mar 18, 2009; 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.