Individual provider Active NPI

Jenna C Warren, PAC

  • Physician Assistant
  • Tacoma, WA
National Provider Identifier
1295218915
Registry record updated Feb 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA61009093 Issued in WA
Practice address
1812 S J St Ste 120
Tacoma, WA 98405-4965
Phone
(253) 428-2200
Fax
(253) 428-2299
NPI assigned
Sep 9, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA61009093 WA Primary

Addresses

Primary practice location

1812 S J St Ste 120
Tacoma, WA 98405-4965

Mailing address

1812 S J St Ste 120
Tacoma, WA 98405-4965
Phone (253) 428-2200

Other identifiers 1

IdentifierTypeStateIssuer
2144963MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20191230001559 WA Practitioner - Physician Assistant 5193159127 Reassigns benefits to 1 organization
I20220421000392 DC Practitioner - Physician Assistant 5193159127 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

15214 Canyon Rd E
Puyallup, WA 98375-7472

1812 S J St
Suite 120
Tacoma, WA 98405-4965
Phone (253) 428-2200

34503 9TH Ave S
Federal Way, WA 98003-8726

3556 Market PL W
Suite 109
University Place, WA 98466-4339
Phone (253) 215-1122

4700 Point Fosdick Dr NW
Gig Harbor, WA 98335-1706

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group CurrentSince Oct 13, 2023 Accepting new patients
Franciscan Medical Group CurrentSince Oct 13, 2023 Accepting new patients
Franciscan Medical Group Physician Assistant Past Accepting new patients

Locations

21 NE Romance Hill Rd
Ste 105
Belfair, WA 98528
Phone (360) 277-2950

9230 Sky Island Dr E
Bonney Lake, WA 98391
Phone (253) 750-6000

9230 Sky Island Dr E
Stop 1201
Bonney Lake, WA 98391

16045 1st Ave S
Fl 1
Burien, WA 98148
Phone (206) 965-4100

34503 9th Ave S
Ste 130
Federal Way, WA 98003
Phone (253) 835-5340

11511 Canterwood Blvd
Ste 100
Gig Harbor, WA 98332
Phone (253) 382-8150

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

11307 Bridgeport Way SW
Ste 220A
Lakewood, WA 98499
Phone (253) 985-2733

450 S Kitsap Blvd
Ste 100
Port Orchard, WA 98366
Phone (360) 744-6275

15214 Canyon Rd E
Ste 120
Puyallup, WA 98375
Phone (253) 539-4200

1344 Wintergreen Ln NE
Unit 100
Seattle, WA 98110
Phone (206) 201-0488

4755 Fauntleroy Way SW
Ste 110
Seattle, WA 98116
Phone (206) 201-0551

4550 Fauntleroy Way SW
Ste 200
Seattle, WA 98126
Phone (206) 933-1041

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

3556 Market Pl W
Ste 109
University Place, WA 98466
Phone (253) 215-1095

Interoperability endpoints

  • Direct secure messaging: jwarren401980@direct.multicare.org

Organizations & group practices 5

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 6

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": "1536451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1295218915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1812 S J ST STE 120",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054965",
            "telephone_number": "253-428-2200",
            "fax_number": "253-428-2299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1812 S J ST STE 120",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054965",
            "telephone_number": "253-428-2200",
            "fax_number": "253-428-2299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARREN",
        "first_name": "JENNA",
        "middle_name": "C",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-09",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61009093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2144963",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.