Jerome Noel Bautista Angeles

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN60649601 Issued in WA

Practice address

14432 Lake Rd
Lynnwood, WA 98087-1712

Phone

(425) 918-2717

NPI assigned

Sep 4, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1567555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567555200000",
    "number": "1215586177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14432 LAKE RD",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980871712",
            "telephone_number": "425-918-2717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14432 LAKE RD",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980871712",
            "telephone_number": "425-918-2717"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14428 Lake Rd",
            "address_purpose": "LOCATION",
            "city": "Lynnwood",
            "state": "WA",
            "postal_code": "980871712",
            "country_code": "US",
            "telephone_number": "425-918-2717",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14422 Lake Rd",
            "address_purpose": "LOCATION",
            "city": "Lynnwood",
            "state": "WA",
            "postal_code": "980871712",
            "country_code": "US",
            "telephone_number": "425-918-2717",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANGELES",
        "first_name": "JEROME NOEL",
        "middle_name": "BAUTISTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-04",
        "last_updated": "2019-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60649601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Appletree Acupuncture Clinic

• Registered Nurse in Lynnwood, WA
• Providers in Lynnwood, WA by specialty
• Registered Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2019; 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.