Jenna Joy Radke

Key facts

NPI

1417845801

Entity type

Individual (NPI type 1)

Primary specialty

Athletic Trainer 2255A2300X

Practice address

1315 Nickell St
Okanogan, WA 98840-9741

Phone

(509) 846-4188

NPI assigned

Jun 25, 2025

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 25, 2025.

{
    "created_epoch": "1750809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1417845801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 NICKELL ST",
            "city": "OKANOGAN",
            "state": "WA",
            "postal_code": "988409741",
            "telephone_number": "509-846-4188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 NICKELL ST",
            "city": "OKANOGAN",
            "state": "WA",
            "postal_code": "988409741",
            "telephone_number": "509-846-4188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADKE",
        "first_name": "JENNA",
        "middle_name": "JOY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-25",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Okanogan, WA

• Okanogan County Transportation & Nutrition
• Okanogan School District #105
• Okanogan Valley Professional Pharmacy LLC
• Trace Jean Paul, LMP
• Planned Parenthood of Greater Washington and North Idaho
• Randal Stephen Rigler, D.D.S.
• Randy Robbins, PA-C
• Robert N. Nau, DDS, LLC
• Ellen Rodgers, ATS
• Jessica Ellen Levonn Russell, DH

All providers in Okanogan, WA · Athletic Trainer in Washington