Individual provider Active NPI

Jennie Olson

  • Pediatric Nurse Practitioner
  • Yakima, WA
National Provider Identifier
1316981665
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
AP60139272 Issued in WA
Practice address
3801 Kern Way
Yakima, WA 98902-6340
Phone
(509) 574-3220
Fax
(509) 574-3211
NPI assigned
Jun 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X RN.310987-COA1 OH
Pediatric Nurse Practitioner 363LP0200X 733750 TX
Pediatric Nurse Practitioner 363LP0200X RN60126218 WA
Pediatric Nurse Practitioner 363LP0200X AP60139272 WA Primary

Addresses

Primary practice location

3801 Kern Way
Yakima, WA 98902-6340

Mailing address

3801 Kern Way
Yakima, WA 98902-6340
Phone (509) 574-3220

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jolson4889@yvfwc.direct-ci.com Direct

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
I20150320000062 WA Practitioner - Nurse Practitioner 3971820531 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN.310987-COA1OHMDPediatric Nurse Practitioner
733750TXMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Yakima Valley Farm Workers Clinic CurrentSince Jun 1, 2020 Accepting new patients

Locations

3801 Kern Rd
Yakima, WA 98902
Phone (509) 574-3200

Interoperability endpoints

  • Direct secure messaging: jolson4889@yvfwc.direct-ci.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1316981665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 KERN WAY",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989026340",
            "telephone_number": "509-574-3220",
            "fax_number": "509-574-3211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 KERN WAY",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989026340",
            "telephone_number": "509-574-3220",
            "fax_number": "509-574-3211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "JENNIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OH",
            "license": "RN.310987-COA1",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "733750",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WA",
            "license": "RN60126218",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WA",
            "license": "AP60139272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jolson4889@yvfwc.direct-ci.com",
            "affiliation": "N",
            "endpointDescription": "YVFWC Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "3801 Kern Way",
            "city": "Yakima",
            "state": "WA",
            "country_code": "US",
            "postal_code": "989026340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.