Individual provider Active NPI

Gaylene Ellin Jarnes, LMP

  • Specialist
  • Bellevue, WA
National Provider Identifier
1649426354
Registry record updated Aug 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA60004256 Issued in WA
Practice address
4307 Factoria Blvd SE
Suite 1
Bellevue, WA 98006-1936
Phone
(425) 747-5657
Fax
(425) 747-5334
NPI assigned
Aug 13, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA60004256 WA Primary

Addresses

Primary practice location

4307 Factoria Blvd SE
Suite 1
Bellevue, WA 98006-1936

Mailing address

4307 Factoria Blvd SE
Suite 1
Bellevue, WA 98006-1936
Phone (425) 747-5657

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
MA60004256WAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1218585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218585600000",
    "number": "1649426354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4307 FACTORIA BLVD SE",
            "address_2": "SUITE 1",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980061936",
            "telephone_number": "425-747-5657",
            "fax_number": "425-747-5334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4307 FACTORIA BLVD SE",
            "address_2": "SUITE 1",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980061936",
            "telephone_number": "425-747-5657",
            "fax_number": "425-747-5334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARNES",
        "first_name": "GAYLENE",
        "middle_name": "ELLIN",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-13",
        "last_updated": "2008-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA60004256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2008; 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.