Active NPI
Jessica Elena Larsen
- Student in an Organized Health Care Education/Training Program
- Olympia, WA
National Provider Identifier
1609477850
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 525 Lilly Rd NE
Olympia, WA 98506-5101 - Phone
- (360) 493-7230
- NPI assigned
- Nov 4, 2020
- Last updated
- Feb 15, 2025
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NU | Primary |
Addresses
Primary practice location
525 Lilly Rd NE
Olympia, WA 98506-5101
Mailing address
4036 Dover CT SE
Olympia, WA 98501-5116
Phone (425) 760-0367
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241104004092 | WA | Order and Referring Only - Family Practice | 7517490188 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739577600000",
"number": "1609477850",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4036 DOVER CT SE",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985015116",
"telephone_number": "425-760-0367"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "525 LILLY RD NE",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985065101",
"telephone_number": "360-493-7230"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSEN",
"first_name": "JESSICA",
"middle_name": "ELENA",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-04",
"last_updated": "2025-02-15",
"certification_date": "2025-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"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 Feb 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.