Active NPI
Jacqueline Cora Ricklick, LPN
- Licensed Practical Nurse
- Olympia, WA
National Provider Identifier
1548610512
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- LPN.LP.00040788
- Practice address
- 4609 Briggs Dr SE
Apt 304
Olympia, WA 98501-5515 - Phone
- (360) 349-3344
- NPI assigned
- Jun 20, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | LPN.LP.00040788 | WA | Primary |
Addresses
Primary practice location
4609 Briggs Dr SE
Apt 304
Olympia, WA 98501-5515
Mailing address
4609 Briggs Dr SE
Apt 304
Olympia, WA 98501-5515
Phone (360) 349-3344
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 164W00000X | Other | WA | LPN |
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
| License | State | Type | Specialty |
|---|---|---|---|
| LPN.LP.00040788 | WA | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466380800000",
"number": "1548610512",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4609 BRIGGS DR SE",
"address_2": "APT 304",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985015515",
"telephone_number": "360-349-3344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4609 BRIGGS DR SE",
"address_2": "APT 304",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985015515",
"telephone_number": "360-349-3344"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICKLICK",
"first_name": "JACQUELINE",
"middle_name": "CORA",
"credential": "LPN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-06-20",
"last_updated": "2016-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "WA",
"license": "LPN.LP.00040788",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LPN",
"identifier": "164W00000X",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Olympia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.