Individual provider Active NPI

Gaojua Juliet Penton

  • Nurse Practitioner
  • Olympia, WA
National Provider Identifier
1275006033
Registry record updated May 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP.AP.61206341-NP Issued in WA
Practice address
406 Black Hills LN SW Ste a
Olympia, WA 98502-8144
Phone
(360) 754-1735
NPI assigned
Jan 4, 2019
Last updated
May 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP.AP.61206341-NP WA Primary

Addresses

Primary practice location

406 Black Hills LN SW Ste a
Olympia, WA 98502-8144

Mailing address

406 Black Hills LN SW Ste a
Olympia, WA 98502-8144
Phone (360) 754-1735

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250304001339 WA Practitioner - Nurse Practitioner 3476896382 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Olympia Multi Specialty ClinicGroup PAC ID 4789571092, 21 clinicians

Practice addresses (Care Compare)

406 Black Hills LN SW
Suite a
Olympia, WA 98502-8144
Phone (360) 754-1727

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP.AP.61206341-NPWAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Olympia Multi Specialty Clinic CurrentSince Apr 1, 2025 Accepting new patients

Locations

406 Black Hills Ln SW
Ste A
Olympia, WA 98502
Phone (360) 754-1727

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1546560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746748800000",
    "number": "1275006033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 BLACK HILLS LN SW STE A",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985028144",
            "telephone_number": "360-754-1735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 BLACK HILLS LN SW STE A",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985028144",
            "telephone_number": "360-754-1735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENTON",
        "first_name": "GAOJUA",
        "middle_name": "JULIET",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-04",
        "last_updated": "2025-05-09",
        "certification_date": "2025-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "ARNP.AP.61206341-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.