Individual provider Active NPI

Jennifer Lee Morrison, M.D.

  • Pediatrics Physician
  • White Salmon, WA
National Provider Identifier
1720428642
Registry record updated Mar 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD61395606 Issued in WA
Practice address
212 NE Skyline Dr
White Salmon, WA 98672-1948
Phone
(509) 637-2810
NPI assigned
Jun 25, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD11111 WA
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X MD61395606 WA Primary

Addresses

Primary practice location

212 NE Skyline Dr
White Salmon, WA 98672-1948

Mailing address

PO Box 99
White Salmon, WA 98672-0099
Phone (509) 637-2810

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20171219002629 OR Practitioner - Pediatric Medicine 6204194327 Reassigns benefits to 1 organization
I20230320000975 WA Practitioner - Pediatric Medicine 6204194327 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD11111WAMDPediatrics Physician
MD61395606WAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Columbia Medical Center Pediatrics Current Accepting new patients
Mid-Columbia Medical Center CurrentSince Dec 1, 2017 Accepting new patients
Public Hospital District No 2, Klickitat County, Washington CurrentSince Feb 1, 2023 Accepting new patients
Mid-Columbia Medical Center CurrentSince Dec 1, 2017 Accepting new patients
Public Hospital District No 2, Klickitat County Washington CurrentSince Feb 1, 2023 Accepting new patients
Public Hospital District No. 2, Klickitat County, Washington Past Accepting new patients

Locations

1620 E 12th St
The Dalles, OR 97058
Phone (541) 296-9151

1805 E 19th St
The Dalles, OR 97058
Phone (541) 296-2201

1935 E 19th St
The Dalles, OR 97058
Phone (541) 223-9018

1700 E 19th St
The Dalles, OR 97058
Phone (541) 296-7251

212 NE Skyline Dr
White Salmon, WA 98672
Phone (509) 493-2133

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/ac6e817f-dc27-43e8-b886-6559f137e853/

Organizations & group practices 6

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": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1720428642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99",
            "city": "WHITE SALMON",
            "state": "WA",
            "postal_code": "986720099",
            "telephone_number": "509-637-2810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 NE SKYLINE DR",
            "city": "WHITE SALMON",
            "state": "WA",
            "postal_code": "986721948",
            "telephone_number": "509-637-2810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRISON",
        "first_name": "JENNIFER",
        "middle_name": "LEE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-25",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD11111",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD61395606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Salmon, WA

Sources for this page

Verify at the official NPI Registry.