Individual provider Active NPI

Elizabeth Jean Jennings, D060446986

  • Optician
  • Sequim, WA
National Provider Identifier
1508559113
Registry record updated May 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
60446986 Issued in WA
Practice address
1284 W Washington St
Sequim, WA 98382-3227
Phone
(360) 683-1590
Fax
(360) 683-7958
NPI assigned
May 30, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 60446986 WA Primary

Addresses

Primary practice location

1284 W Washington St
Sequim, WA 98382-3227

Mailing address

1284 W Washington St
Sequim, WA 98382-3227
Phone (360) 683-1590

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
60446986WAMDOptician

NPI Registry JSON

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

{
    "created_epoch": "1685404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1508559113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1284 W WASHINGTON ST",
            "city": "SEQUIM",
            "state": "WA",
            "postal_code": "983823227",
            "telephone_number": "360-683-1590",
            "fax_number": "360-683-7958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1284 W WASHINGTON ST",
            "city": "SEQUIM",
            "state": "WA",
            "postal_code": "983823227",
            "telephone_number": "360-683-1590",
            "fax_number": "360-683-7958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "ELIZABETH",
        "middle_name": "JEAN",
        "credential": "D060446986",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-30",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "WA",
            "license": "60446986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sequim, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.