Jackline Munene

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

61192030 Issued in WA

Practice address

11100 SE Petrovitsky Rd Apt Q201
Renton, WA 98055-6467

Phone

(253) 993-1293

NPI assigned

Sep 29, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Molina Healthcare of Washington, Inc

  • Family Medicine Physician
  • Bothell, WA
  • NPI 1659897163
  NPD
• Molina Healthcare of Washington, Inc

  • Family Medicine Physician
  • Everett, WA
  • NPI 1912235060
  NPD

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

{
    "created_epoch": "1632873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642118400000",
    "number": "1184396194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "MIL",
            "address_1": "CMR 402 BOX 11",
            "city": "APO",
            "state": "AE",
            "postal_code": "091800001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 SE PETROVITSKY RD APT Q201",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980556467",
            "telephone_number": "253-993-1293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNENE",
        "first_name": "JACKLINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-29",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "61192030",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "61192030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mrmassage,Inc.
• Matthew Mulder, MD
• Kathleen E Mulligan Solly, PT
• Kendra Nicole Mullin
• Julia K. Mullins, L.M.P.
• Margaret Munene
• Pathcharaporn Mungsawat, LMP
• Terri Muraglia, LMP
• Valerie Leeann Murakami, DNP-PMHNP
• Rik Hiroshi Muroya, LMHC, NCC

• Nurse Practitioner in Renton, WA
• Providers in Renton, WA by specialty
• Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.