Individual provider Active NPI

Jamie Lynn Beardsley, RN

  • Registered Nurse
  • Deer Park, WA
National Provider Identifier
1720207129
Registry record updated Mar 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN60573882 Issued in WA
Practice address
303 W Owens Rd
Deer Park, WA 99006-9321
Phone
(206) 409-8310
Fax
(509) 297-7903
NPI assigned
Apr 24, 2007
Last updated
Mar 24, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA00016719 WA
Registered Nurse 163W00000X RN60573882 WA Primary

Addresses

Primary practice location

303 W Owens Rd
Deer Park, WA 99006-9321

Mailing address

303 W Owens Rd
Deer Park, WA 99006-9321
Phone (206) 409-8310

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN60573882WAMDRegistered Nurse
MA00016719WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Nurse Delegation PLLC Registered Nurse CurrentSince Jan 22, 2023 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1720207129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 W OWENS RD",
            "city": "DEER PARK",
            "state": "WA",
            "postal_code": "990069321",
            "telephone_number": "206-409-8310",
            "fax_number": "509-297-7903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 W OWENS RD",
            "city": "DEER PARK",
            "state": "WA",
            "postal_code": "990069321",
            "telephone_number": "206-409-8310",
            "fax_number": "509-297-7903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEARDSLEY",
        "first_name": "JAMIE",
        "middle_name": "LYNN",
        "name_prefix": "Miss",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-24",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00016719",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60573882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deer Park, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2021; 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.