Individual provider Active NPI

Emma Olson Jackson, PNP

  • Pediatric Nurse Practitioner
  • Seattle, WA
National Provider Identifier
1306114442
Registry record updated Sep 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
AP60822575 Issued in WA
Practice address
4800 Sand Point Way NE
Seattle, WA 98105-3901
Phone
(206) 987-0366
NPI assigned
Dec 4, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 201403443NP OR
Pediatric Nurse Practitioner 363LP0200X 21356 CA
Pediatric Nurse Practitioner 363LP0200X AP60822575 WA Primary

Addresses

Primary practice location

4800 Sand Point Way NE
Seattle, WA 98105-3901

Mailing address

PO Box 5371
Seattle, WA 98145-5005
Phone (206) 987-0366

Other practice location 1

707 SW Gaines St
CDRC-P
Portland, OR 97239-2901
Phone (503) 494-2192

Other names 1

  • Emma Digby Olson Former name

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
I20180321001029 WA Practitioner - Nurse Practitioner 5991024408 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21356CAMDPediatric Nurse Practitioner
AP60822575WAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Association of CHMC and University Physicians CurrentSince Jan 17, 2022 Accepting new patients
The Association of University Physicians CurrentSince Nov 18, 2019 Accepting new patients
Seattle Childrens Hospital CurrentSince Mar 6, 2018 Accepting new patients
Seattle Children'S Hospital Current Accepting new patients
Seattle Children'S Hospital CurrentSince Mar 6, 2018 Accepting new patients
The Association of Chrmc and University Physicians CurrentSince Jan 17, 2022 Accepting new patients
Seattle Children'S Hospital Past Accepting new patients

Locations

1035 116th Ave NE
Bellevue, WA 98004
Phone (425) 451-4141

900 Pacific Ave
Ste 100
Everett, WA 98201
Phone (425) 304-6080

8232 W Grandridge Blvd
Kennewick, WA 99336
Phone (509) 582-1700

4800 Sand Point Way NE
Seattle, WA 98105
Phone (206) 526-2000

1959 NE Pacific St
Seattle, WA 98195
Phone (206) 598-4333

1780 NW Myhre Rd
Ste 2120
Silverdale, WA 98383
Phone (360) 782-3100

Interoperability endpoints

  • Direct secure messaging: ejackson35263@direct.seattlechildrens.org

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1322956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536537600000",
    "number": "1306114442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5371",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981455005",
            "telephone_number": "206-987-0366",
            "fax_number": "206-987-3839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 SAND POINT WAY NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981053901",
            "telephone_number": "206-987-0366"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "707 SW Gaines St",
            "address_2": "CDRC-P",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972392901",
            "country_code": "US",
            "telephone_number": "503-494-2192",
            "fax_number": "503-494-2824",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "EMMA",
        "middle_name": "OLSON",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-04",
        "last_updated": "2018-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OR",
            "license": "201403443NP",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "21356",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WA",
            "license": "AP60822575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMMA",
            "last_name": "OLSON",
            "middle_name": "DIGBY",
            "credential": "PNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.