Individual provider Active NPI

Helina Endale Jimma, ARNP

  • Geriatric Medicine (Family Medicine) Physician
  • Renton, WA
National Provider Identifier
1679256861
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
AP61458067 Issued in WA
Practice address
707 S Grady Way Ste 400
Renton, WA 98057-3201
Phone
(425) 516-1042
NPI assigned
Aug 14, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X AP61458067 WA Primary

Addresses

Primary practice location

707 S Grady Way Ste 400
Renton, WA 98057-3201

Mailing address

15647 129TH PL SE
Renton, WA 98058-4744
Phone (425) 516-1042

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
I20251016004837 WA Practitioner - Nurse Practitioner 6204371305 Practice locations: Tacoma, WA

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2302 S Union Ave
Suite C30
Tacoma, WA 98405-1334
Phone (425) 738-7942

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nebicare Current Accepting new patients
Nebicare PLLC CurrentSince Aug 1, 2025 Accepting new patients

Locations

2302 S Union Ave
Ste C30
Tacoma, WA 98405
Phone (253) 468-7200

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1691971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1679256861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15647 129TH PL SE",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980584744",
            "telephone_number": "425-516-1042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 S GRADY WAY STE 400",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980573201",
            "telephone_number": "425-516-1042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMMA",
        "first_name": "HELINA",
        "middle_name": "ENDALE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-14",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "WA",
            "license": "AP61458067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

Verify at the official NPI Registry.