Individual provider Active NPI

Jason Frederick Stutzman, FNP-BC, MSN, BSN

  • Gerontology Nurse Practitioner
  • Everett, WA
National Provider Identifier
1619224508
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
AP60581583 Issued in WA
Practice address
220 Olympic Blvd
Everett, WA 98203-1918
Phone
(206) 582-4601
Fax
(206) 582-4698
NPI assigned
Aug 9, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AP60581583 WA
Family Nurse Practitioner 363LF0000X AP60581583 WA
Family Nurse Practitioner 363LF0000X 21511 CA
Gerontology Nurse Practitioner 363LG0600X AP60581583 WA Primary

Addresses

Primary practice location

220 Olympic Blvd
Everett, WA 98203-1918

Mailing address

8214 156TH St SE
Snohomish, WA 98296-8728
Phone (559) 321-6211

Other practice location 1

8214 156th St SE
Snohomish, WA 98296-8728
Phone (559) 321-6211

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150721001375 WA Order and Referring Only - Nurse Practitioner 5193038032

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
21511CAMDSpeech-Language Pathologist

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1344470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1619224508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8214 156TH ST SE",
            "city": "SNOHOMISH",
            "state": "WA",
            "postal_code": "982968728",
            "telephone_number": "559-321-6211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 OLYMPIC BLVD",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982031918",
            "telephone_number": "206-582-4601",
            "fax_number": "206-582-4698"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8214 156th St SE",
            "address_purpose": "LOCATION",
            "city": "Snohomish",
            "state": "WA",
            "postal_code": "982968728",
            "country_code": "US",
            "telephone_number": "559-321-6211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STUTZMAN",
        "first_name": "JASON",
        "middle_name": "FREDERICK",
        "name_prefix": "Mr.",
        "credential": "FNP-BC, MSN, BSN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-09",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WA",
            "license": "AP60581583",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60581583",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "21511",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WA",
            "license": "AP60581583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.