Individual provider Active NPI

Jacqueline Marie Justus, ARNP

  • Pediatric Nurse Practitioner
  • Seattle, WA
National Provider Identifier
1336488915
Registry record updated Feb 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
AP60332817 Issued in WA
Practice address
4400 37TH Ave S
Seattle, WA 98118-1609
Phone
(206) 296-4650
NPI assigned
Feb 2, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X AP60332817 WA Primary

Addresses

Primary practice location

4400 37TH Ave S
Seattle, WA 98118-1609

Mailing address

4400 37TH Ave S
Seattle, WA 98118-1609
Phone (206) 296-4650

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
I20150226002367 WA Practitioner - Nurse Practitioner 9234455718 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP60332817WAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborcare Health Current Accepting new patients
Neighborcare Health CurrentSince Feb 20, 2023 Accepting new patients
Harborview Medical Center Past Accepting new patients
Neighborcare Health Past Accepting new patients

Locations

4400 37th Ave S
Seattle, WA 98118
Phone (206) 296-4650

1629 N 45th St
Seattle, WA 98103
Phone (206) 633-3350

6020 35th Ave SW
Seattle, WA 98126
Phone (206) 461-6950

12721 30th Ave NE
Ste 101
Seattle, WA 98125
Phone (206) 417-0326

9245 Rainier Ave S
Seattle, WA 98118
Phone (206) 461-6981

Interoperability endpoints

  • Direct secure messaging: jjustus296042@direct.ochin.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1359763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359763200000",
    "number": "1336488915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 37TH AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981181609",
            "telephone_number": "206-296-4650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 37TH AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981181609",
            "telephone_number": "206-296-4650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSTUS",
        "first_name": "JACQUELINE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-02",
        "last_updated": "2013-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WA",
            "license": "AP60332817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.