NPIMap

Individual provider Active NPI

Jensen Lund Nelson, PA-C

  • Medical Physician Assistant
  • Kent, WA
National Provider Identifier
1437339942
Registry record updated Sep 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA10003776 Issued in WA
Practice address
521 2ND Place North
M/S KSC 11-103
Kent, WA 98032
Phone
(425) 690-3491
Fax
(425) 690-9091
NPI assigned
Nov 13, 2007
Last updated
Sep 24, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA10003776 WA Primary

Addresses

Primary practice location

521 2ND Place North
M/S KSC 11-103
Kent, WA 98032

Mailing address

3600 Lind Ave SW Ste 100
Renton, WA 98057-4970
Phone (425) 228-3440

Other identifiers 1

IdentifierTypeStateIssuer
2024575MedicaidWA

Other names 1

  • Elizabeth Jensen Lund Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161222000993 WA Practitioner - Physician Assistant 5496036873 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Valley Medical Group-RentonGroup PAC ID 4183753965, 419 clinicians

Practice addresses (Care Compare)

16850 SE 272ND St
Covington, WA 98042-4931

521 2ND PL N
11 103
Kent, WA 98032-4537
Phone (425) 690-3491

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Mason Medical Center CurrentSince Jan 12, 2017 Accepting new patients
Virginia Mason Medical Center CurrentSince Jan 12, 2017 Accepting new patients
Plateau Family Medicine, PS Past Accepting new patients
Public Hospital District #1 of King County Past Accepting new patients

Locations

380 Winslow Way E
Bainbridge Island, WA 98110
Phone (206) 842-5632

1818 Cole St
Enumclaw, WA 98022
Phone (360) 802-5760

33501 1st Way S
Federal Way, WA 98003
Phone (253) 838-2400

4575 Sand Point Way NE
Ste 108
Seattle, WA 98105
Phone (206) 525-8000

925 Seneca St
Seattle, WA 98101
Phone (206) 341-0860

Interoperability endpoints

  • Direct secure messaging: jnelson72589@direct.valleymed.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1194912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537747200000",
    "number": "1437339942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 LIND AVE SW STE 100",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980574970",
            "telephone_number": "425-228-3440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 2ND PLACE NORTH",
            "address_2": "M/S KSC 11-103",
            "city": "KENT",
            "state": "WA",
            "postal_code": "98032",
            "telephone_number": "425-690-3491",
            "fax_number": "425-690-9091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "JENSEN",
        "middle_name": "LUND",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-13",
        "last_updated": "2018-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA10003776",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2024575",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "LUND",
            "middle_name": "JENSEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kent, WA

Sources for this page

Verify at the official NPI Registry.