Jacqualine Savanna Boles, RN, CN, MSN

Primary specialty

Child & Adolescent Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0807X

License

RN00117868 Issued in WA

Practice address

8314 Renton Ave S
Seattle, WA 98118-4639

Phone

(206) 723-1590

NPI assigned

Aug 31, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science - Nursing, Registered Nurse

State licenses

Practice roles

Locations

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.

• Redeemed by the Blood Pentecostal Church

  • Community/Behavioral Health Agency
  • Seattle, WA
  • NPI 1508591835
  NPD Authorized official

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

{
    "created_epoch": "1661904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1598485302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8318 RENTON AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981184639",
            "telephone_number": "206-723-1590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8314 RENTON AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981184639",
            "telephone_number": "206-723-1590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLES",
        "first_name": "JACQUALINE",
        "middle_name": "SAVANNA",
        "credential": "RN, CN, MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-31",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "WA",
            "license": "RN00117868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aleks Boldyrev
• Medhavi Bole, M.D.
• Elizabeth Louise Bolen, M.D.
• Hanz William Bolen, MSW
• John W Bolen, MD
• Candice Boley, MD
• Christine Lynn Boley, ARNP
• Lauren Bolger
• Nefeteria Louise Bolin, BA, MA
• Mary Katherine Bolinger, LMP, L.AC.

• Child & Adolescent Psychiatric/Mental Health Registered Nurse in Seattle, WA
• Providers in Seattle, WA by specialty
• Child & Adolescent Psychiatric/Mental Health Registered Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; 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.