Jannelle Marie Fukuji, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA171607 Issued in OR

Practice address

9495 SW Locust St
Suite a
Portland, OR 97223-6683

Phone

(503) 696-9011

Fax

(503) 696-3952

NPI assigned

Dec 22, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Seattle Childrens HospitalGroup PAC ID 9032021050, 113 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jfukuji492674@direct.multicare.org
• Direct secure messaging: jannelledupuis@aaica.allscriptsdirect.net
• Direct secure messaging: jfukuji400801@direct.seattlechildrens.org

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.

• Seattle Children'S Hospital

  • Specialist
  • Seattle, WA
  • NPI 1003319500
  Medicare reassignment Care Compare group
• Allergy & Asthma Specialty Service PS

  • Allergy & Immunology Physician
  • Lakewood, WA
  • NPI 1457461410
  Medicare reassignment
• Seattle Children'S Hospital

  • Primary Care Clinic/Center
  • Seattle, WA
  • NPI 1134251747
  NPD
• Seattle Childrens Hospital

  • Clinic Pharmacy
  • Seattle, WA
  • NPI 1245342153
  NPD
• Seattle Children'S Hospital

  • Home Infusion Agency
  • Bothell, WA
  • NPI 1245383348
  NPD (past)

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

{
    "created_epoch": "1324512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553558400000",
    "number": "1396014114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9495 SW LOCUST ST",
            "address_2": "SUITE A",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972236683",
            "telephone_number": "503-696-9011",
            "fax_number": "503-696-3952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9495 SW LOCUST ST",
            "address_2": "SUITE A",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972236683",
            "telephone_number": "503-696-9011",
            "fax_number": "503-696-3952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUKUJI",
        "first_name": "JANNELLE",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-22",
        "last_updated": "2019-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA171607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Craig Isamu Fujiwara, O.D.
• Yuichi Fukada, LMT
• Dawn Chieko Fuke, PHARMD, BCPS
• Derrin Yoshio Kilipaki Fukuda, PSY.D.
• Toshinori Fukuda, MD
• Summer Anne-Marie Fulcher
• Davia Fulford
• Deborah K Fulkerson, OT
• Full Circle Community Services
• Full Circle Ecotherapy and Family Services LLC

• Medical Physician Assistant in Portland, OR
• Providers in Portland, OR by specialty
• Medical Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.