Individual provider Active NPI

Jennifer M Klein, DO

  • Family Medicine Physician
  • Seattle, WA
National Provider Identifier
1376863258
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OP60305926 Issued in WA
Practice address
12345 Lake City Way NE # 3161
Seattle, WA 98125-5401
Phone
(206) 880-3789
Fax
(833) 968-1124
NPI assigned
Jun 2, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OP60305926 WA Primary

Addresses

Primary practice location

12345 Lake City Way NE # 3161
Seattle, WA 98125-5401

Mailing address

12345 Lake City Way NE # 3161
Seattle, WA 98125-5401
Phone (206) 880-3789

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131213000203 WA Practitioner - Family Practice 9638306897 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OP60305926WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of Washington CurrentSince Sep 28, 2013 Accepting new patients
Overlake Medical Clinics LLC CurrentSince Nov 14, 2016 Accepting new patients
Overlake Medical Clinics, LLC Current Accepting new patients
Kaiser Foundation Health Plan of Washington Current Accepting new patients

Locations

1750 112th Ave NE
Ste B102
Bellevue, WA 98004
Phone (425) 688-5460

1417 116th Ave NE
Ste 110
Bellevue, WA 98004
Phone (425) 688-5700

201 16th Ave E
Seattle, WA 98112
Phone (206) 326-4545

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

125 16th Ave E
#160
Seattle, WA 98112

322 W North River Dr
Spokane, WA 99201
Phone (509) 241-2575

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Interoperability endpoints

  • Direct secure messaging: jklein29924@ghc.direct-ci.net
  • Direct secure messaging: jennifer.klein@217526021193732.direct.elationemr.com

Organizations & group practices 4

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": "1275436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1376863258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12345 LAKE CITY WAY NE # 3161",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981255401",
            "telephone_number": "206-880-3789",
            "fax_number": "833-968-1124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12345 LAKE CITY WAY NE # 3161",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981255401",
            "telephone_number": "206-880-3789",
            "fax_number": "833-968-1124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEIN",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-02",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP60305926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.