Active NPI
Jennifer Tynna Irwin, BS
- Mental Health Counselor
- Lakewood, WA
National Provider Identifier
1144875899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 9330 59TH Ave SW
Lakewood, WA 98499-2858 - Phone
- (253) 620-5015
- NPI assigned
- Aug 8, 2019
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | WA | Primary |
Addresses
Primary practice location
9330 59TH Ave SW
Lakewood, WA 98499-2858
Mailing address
9330 59TH Ave SW
Lakewood, WA 98499-2858
Phone (253) 620-5015
Other names 1
- Jennifer Tynna Kallerson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 17, 2025 through Jul 17, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565222400000",
"number": "1144875899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9330 59TH AVE SW",
"city": "LAKEWOOD",
"state": "WA",
"postal_code": "984992858",
"telephone_number": "253-620-5015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9330 59TH AVE SW",
"city": "LAKEWOOD",
"state": "WA",
"postal_code": "984992858",
"telephone_number": "253-620-5015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IRWIN",
"first_name": "JENNIFER",
"middle_name": "TYNNA",
"credential": "BS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-08",
"last_updated": "2019-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "KALLERSON",
"middle_name": "TYNNA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Lakewood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.