Individual provider Active NPI

Lourdes C Jose, ARNP

  • Adult Health Nurse Practitioner
  • Renton, WA
National Provider Identifier
1386958692
Registry record updated Apr 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP60146966 Issued in WA
Practice address
3600 Lind Ave SW
Ste 170
Renton, WA 98057-4934
Phone
(425) 656-5439
Fax
(425) 656-5493
NPI assigned
Jul 28, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AP60146966 WA Primary

Addresses

Primary practice location

3600 Lind Ave SW
Ste 170
Renton, WA 98057-4934

Mailing address

3600 Lind Ave SW
Ste 170
Renton, WA 98057-4934
Phone (425) 656-5439

Other practice location 1

113 23rd Ave S
Seattle, WA 98144-2309
Phone (206) 219-5980

Other practice location 2

8720 14th Ave S
Seattle, WA 98108-4807
Phone (206) 762-3730

Other practice location 3

113 23rd Ave S
Seattle, WA 98144-2309
Phone (206) 709-1777

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
I20150602002651 WA Practitioner - Nurse Practitioner 8022339019 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sea Mar Community Health CentersGroup PAC ID 7315831161, 235 clinicians

Practice addresses (Care Compare)

8720 14TH Ave S
Seattle, WA 98108-4807
Phone (206) 762-3730

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sea Mar Community Health Centers Current Accepting new patients
Sea Mar Community Health Centers CurrentSince Mar 7, 2015 Accepting new patients
Sea Mar Community Health Centers CurrentSince Mar 7, 2015 Accepting new patients
Sea-Mar Community Health Center Past Accepting new patients
Sea Mar Community Health Centers PastSince Feb 2, 2025 Accepting new patients

Locations

8720 14th Ave S
Seattle, WA 98108
Phone (206) 762-3730

Interoperability endpoints

  • Direct secure messaging: ljose450541@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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1280275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743724800000",
    "number": "1386958692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 LIND AVE SW",
            "address_2": "STE 170",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980574934",
            "telephone_number": "425-656-5439",
            "fax_number": "425-656-5493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 LIND AVE SW",
            "address_2": "STE 170",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980574934",
            "telephone_number": "425-656-5439",
            "fax_number": "425-656-5493"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "113 23rd Ave S",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981442309",
            "country_code": "US",
            "telephone_number": "206-219-5980",
            "fax_number": "206-812-6161",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8720 14th Ave S",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981084807",
            "country_code": "US",
            "telephone_number": "206-762-3730",
            "fax_number": "206-764-0523",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "113 23rd Ave S",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981442309",
            "country_code": "US",
            "telephone_number": "206-709-1777",
            "fax_number": "206-860-9846",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOSE",
        "first_name": "LOURDES",
        "middle_name": "C",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-28",
        "last_updated": "2025-04-04",
        "certification_date": "2025-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WA",
            "license": "AP60146966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

Verify at the official NPI Registry.