Jennifer Fresh, PMHNP, ARNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP61193529 Issued in WA

Practice address

7700 NE 26TH Ave
Vancouver, WA 98665-0672

Phone

(360) 397-8228

Fax

(360) 353-9440

NPI assigned

Apr 5, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cowlitz Indian TribeGroup PAC ID 8820030133, 26 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Cowlitz Indian Tribe

  • Clinic/Center
  • Longview, WA
  • NPI 1740562909

  TX

  Medicare reassignment Care Compare group NPD
• Cowlitz Indian Tribe

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Vancouver, WA
  • NPI 1538412630
  NPD
• Cowlitz Indian Tribe

  • General Practice Physician
  • Longview, WA
  • NPI 1851328447
  NPD (past)

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

{
    "created_epoch": "1459814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1760845853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2429",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986328486",
            "telephone_number": "360-353-9494",
            "fax_number": "360-353-9440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7700 NE 26TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986650672",
            "telephone_number": "360-397-8228",
            "fax_number": "360-353-9440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRESH",
        "first_name": "JENNIFER",
        "credential": "PMHNP, ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-05",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61193529",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "201507213RN",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Naomi Frein
• Matthew French Wallace, PA-C
• Kaia Butzman French, DPT
• Katelyn Frentress, DPT
• Fresh Horizons Massage LLC
• Jon Frew, PH.D
• Patricia Marie Frew, MD
• Blake Gregory Frey, MA
• Sarah Lynn Lovell Frey, M.D.
• Angela Dawn Freyer, MOTR/L

• All providers in Vancouver, WA
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.