Active NPI
Jennifer Marie Travis, RNFA
- Registered Nurse First Assistant
- Eatonville, WA
National Provider Identifier
1639536907
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse First Assistant
- License
- RN00158218
- Practice address
- 12018 Clear Lake South Rd E
Eatonville, WA 98328-8300 - Phone
- (253) 312-8394
- NPI assigned
- Jan 18, 2016
- 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 |
|---|---|---|---|---|
| Registered Nurse First Assistant | 163WR0006X | RN00158218 | WA | Primary |
Addresses
Primary practice location
12018 Clear Lake South Rd E
Eatonville, WA 98328-8300
Mailing address
12018 Clear Lake South Rd E
Eatonville, WA 98328-8300
Phone (253) 312-8394
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
| License | State | Type | Specialty |
|---|---|---|---|
| RN00158218 | WA | MD | Registered Nurse First Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1453075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1453075200000",
"number": "1639536907",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12018 CLEAR LAKE SOUTH RD E",
"city": "EATONVILLE",
"state": "WA",
"postal_code": "983288300",
"telephone_number": "253-312-8394"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12018 CLEAR LAKE SOUTH RD E",
"city": "EATONVILLE",
"state": "WA",
"postal_code": "983288300",
"telephone_number": "253-312-8394"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRAVIS",
"first_name": "JENNIFER",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "RNFA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-01-18",
"last_updated": "2016-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "163WR0006X",
"taxonomy_group": "",
"desc": "Registered Nurse, Registered Nurse First Assistant",
"state": "WA",
"license": "RN00158218",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eatonville, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.