Jillian Kay Darlene Douglas, PMHNP, ARNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP61231963 Issued in WA

Practice address

2601 Summit Ave
Everett, WA 98201-3309

Phone

(425) 258-2407

Fax

(425) 339-2601

NPI assigned

Feb 12, 2024

Sex

Female

Sole proprietor

No

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

Practice roles

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.

• Evergreen Recovery Centers-Lynnwood Detox

  • Substance Abuse Rehabilitation Facility
  • Lynnwood, WA
  • NPI 1588184980
  NPD (past)

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

{
    "created_epoch": "1707696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1285498097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12317 40TH AVE NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981255730",
            "telephone_number": "206-992-1313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 SUMMIT AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982013309",
            "telephone_number": "425-258-2407",
            "fax_number": "425-339-2601"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20508 56th Ave W",
            "address_purpose": "LOCATION",
            "city": "Lynnwood",
            "state": "WA",
            "postal_code": "980367650",
            "country_code": "US",
            "telephone_number": "425-678-1390",
            "fax_number": "425-678-8661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "JILLIAN",
        "middle_name": "KAY DARLENE",
        "name_prefix": "Dr.",
        "credential": "PMHNP, ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-12",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61231963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dustin Doty
• Robert C Doty
• John Joseph Dougherty, PHARMD
• Allyson Kaye Douglas, MA, LMFTA, MHP, CMHS
• Ayeshia Douglas
• Jasmine Robin Douglass
• Gabrielle J. Douthitt, ARNP
• Charlene Downes, CCC-SP
• Amy Downs, NP
• Patty Lynn Downs

• Psychiatric/Mental Health Nurse Practitioner in Everett, WA
• Providers in Everett, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 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.

Verify at the official NPI Registry.