Individual provider Active NPI

Jennifer Bryan, DO

  • Neuromusculoskeletal Medicine & OMM Physician
  • Ellensburg, WA
National Provider Identifier
1558090878
Registry record updated Aug 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X
License
DO.OP.70012965 Issued in WA
Practice address
100 E Jackson Ave
Ellensburg, WA 98926-3692
Phone
(509) 933-8777
NPI assigned
Jun 10, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X DO.OP.70012965 WA Primary

Addresses

Primary practice location

100 E Jackson Ave
Ellensburg, WA 98926-3692

Mailing address

100 E Jackson Ave
Ellensburg, WA 98926-3692
Phone (509) 933-8777

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250820004539 WA Practitioner - General Practice 3476053851 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DO.OP.70012965WAMDNeuromusculoskeletal Medicine & OMM Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kittitas County Public Hospital Dist 1 Current Accepting new patients
Kittitas County Public Hospital Dist 1 CurrentSince Jul 31, 2025 Accepting new patients
Kittitas County Public Hosp Dist 1 CurrentSince Jul 31, 2025 Accepting new patients
Kittitas County Public Hospital Dist 1 Past Accepting new patients

Locations

100 E Jackson Ave
Ellensburg, WA 98926
Phone (509) 574-6000

603 S Chestnut St
Ellensburg, WA 98926
Phone (509) 933-8693

Organizations & group practices 8

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.

Hospital & facility affiliations 1

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

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kittitas County Public Hospital Dist 1 82 clinicians

Practice addresses (Care Compare)

100 E Jackson Ave
Ellensburg, WA 98926-3692
Phone (509) 933-8777

Hospital & facility affiliations

  • Kittitas Valley Community Hospital Hospital, Ellensburg, WA, CCN 501333

NPI Registry JSON

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

{
    "created_epoch": "1654819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754784000000",
    "number": "1558090878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E JACKSON AVE",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989263692",
            "telephone_number": "509-933-8777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E JACKSON AVE",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989263692",
            "telephone_number": "509-933-8777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYAN",
        "first_name": "JENNIFER",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-10",
        "last_updated": "2025-08-10",
        "certification_date": "2025-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "WA",
            "license": "DO.OP.70012965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellensburg, WA

Sources for this page

Verify at the official NPI Registry.