Active NPI
Jacqueline R Lemon I, LMP
- Contractor
- Vancouver, WA
National Provider Identifier
1689075848
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- MA 60486698
- Practice address
- 12214 SE Mill Plain Blvd
Suite 101
Vancouver, WA 98684-6019 - Phone
- (360) 944-1800
- NPI assigned
- Sep 8, 2014
- Last updated
- Sep 8, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Contractor | 171W00000X | MA 60486698 | WA | Primary |
Addresses
Primary practice location
12214 SE Mill Plain Blvd
Suite 101
Vancouver, WA 98684-6019
Mailing address
126 NW Homeward Ave
Stevenson, WA 98648-6639
Phone (360) 597-8577
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 |
|---|---|---|---|
| MA 60486698 | WA | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410134400000",
"number": "1689075848",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "126 NW HOMEWARD AVE",
"city": "STEVENSON",
"state": "WA",
"postal_code": "986486639",
"telephone_number": "360-597-8577"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12214 SE MILL PLAIN BLVD",
"address_2": "SUITE 101",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986846019",
"telephone_number": "360-944-1800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEMON",
"first_name": "JACQUELINE",
"middle_name": "R",
"name_prefix": "Miss",
"name_suffix": "I",
"credential": "LMP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-09-08",
"last_updated": "2014-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "WA",
"license": "MA 60486698",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.