Individual provider Active NPI

Jennifer Renee Paloma, LMP

  • Specialist
  • Olympia, WA
National Provider Identifier
1285761056
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA00020082 Issued in WA
Practice address
302 Columbia St NW
Olympia, WA 98501-1031
Phone
(360) 350-2762
NPI assigned
Feb 27, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA00020082 WA Primary

Addresses

Primary practice location

302 Columbia St NW
Olympia, WA 98501-1031

Mailing address

5640 Indian Crest LN NE # a
Olympia, WA 98516-9586
Phone (360) 412-0951

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

LicenseStateTypeSpecialty
MA00020082WAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285761056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5640 INDIAN CREST LN NE # A",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985169586",
            "telephone_number": "360-412-0951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 COLUMBIA ST NW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985011031",
            "telephone_number": "360-350-2762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALOMA",
        "first_name": "JENNIFER",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA00020082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.