Individual provider Active NPI

Jennifer Lee Havlin

  • Ambulatory Care Registered Nurse
  • Seattle, WA
National Provider Identifier
1558879650
Registry record updated Jan 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Care Registered NurseTaxonomy code 163WP2201X
License
RN00138213 Issued in WA
Practice address
400 23Rd Ave # 102
Seattle, WA 98122-6025
Phone
(206) 252-2277
NPI assigned
Jan 11, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Care Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WP2201X RN00138213 WA Primary

Addresses

Primary practice location

400 23Rd Ave # 102
Seattle, WA 98122-6025

Mailing address

12025 SE 60TH St
Bellevue, WA 98006-3803

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
RN00138213WAMDAmbulatory Care Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1515628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515628800000",
    "number": "1558879650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12025 SE 60TH ST",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980063803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 23RD AVE # 102",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981226025",
            "telephone_number": "206-252-2277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVLIN",
        "first_name": "JENNIFER",
        "middle_name": "LEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-11",
        "last_updated": "2018-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP2201X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "WA",
            "license": "RN00138213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2018; 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.