Jacqueline Marie Roth

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SC61633275 Issued in WA

Practice address

5700 172ND St NE
Arlington, WA 98223-7742

Phone

(360) 652-9640

Fax

(360) 652-2093

NPI assigned

Sep 9, 2019

Last updated

Apr 6, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Stillaguamish Tribal Health Clinic

  • General Practice Physician
  • Arlington, WA
  • NPI 1164451142
  NPD (past)

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

{
    "created_epoch": "1567987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775433600000",
    "number": "1669021952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 172ND ST NE",
            "city": "ARLINGTON",
            "state": "WA",
            "postal_code": "982237742",
            "telephone_number": "360-652-9640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 172ND ST NE",
            "city": "ARLINGTON",
            "state": "WA",
            "postal_code": "982237742",
            "telephone_number": "360-652-9640",
            "fax_number": "360-652-2093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "JACQUELINE",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-09",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "SC61633275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey B. Ronning, D.C.
• Jolene Ronning, LMP
• Karyn Michelle Rosebrook-Morris, LMP
• Stan V Rosebrook, D.C.
• Julie Ross
• Katrina Roys, PA
• Ellen Jane Rudy, CPCP
• Lisa Marie Ruppert, LSWAIC
• Samantha Erin Rushton, MS LMFT
• Jesse Cohen Russell, RN

• Clinical Social Worker in Arlington, WA
• Providers in Arlington, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2026; 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.