Active NPI
Jensen Dockendorf
- Family Nurse Practitioner
- Monroe, WA
National Provider Identifier
1235909243
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- AP61514430
- Practice address
- 909 W Main St Ste 109
Monroe, WA 98272-2031 - Phone
- (425) 418-2434
- NPI assigned
- Jan 2, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | AP61514430 | WA | Primary |
Addresses
Primary practice location
909 W Main St Ste 109
Monroe, WA 98272-2031
Mailing address
5210 200TH St NE
Arlington, WA 98223-8710
Phone (425) 870-2572
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
| License | State | Type | Specialty |
|---|---|---|---|
| AP61514430 | WA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1704153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704412800000",
"number": "1235909243",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5210 200TH ST NE",
"city": "ARLINGTON",
"state": "WA",
"postal_code": "982238710",
"telephone_number": "425-870-2572"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "909 W MAIN ST STE 109",
"city": "MONROE",
"state": "WA",
"postal_code": "982722031",
"telephone_number": "425-418-2434"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOCKENDORF",
"first_name": "JENSEN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-01-02",
"last_updated": "2024-01-05",
"certification_date": "2024-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "WA",
"license": "AP61514430",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Monroe, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 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.