Individual provider Active NPI

Jaclyn Nicole Sison, APRN

  • Family Nurse Practitioner
  • Tumwater, WA
National Provider Identifier
1780578765
Registry record updated Jun 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP70009126 Issued in WA
Practice address
2227 79TH Ave SE
Tumwater, WA 98501-6803
Phone
(206) 422-6857
NPI assigned
Jun 5, 2025
Last updated
Jun 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP70009126 WA Primary

Addresses

Primary practice location

2227 79TH Ave SE
Tumwater, WA 98501-6803

Mailing address

2227 79TH Ave SE
Tumwater, WA 98501-6803
Phone (206) 422-6857

Other names 1

  • Miss Jaclyn Nicole Ferrer Former name

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
I20250923003806 WA Practitioner - Nurse Practitioner 8921503707 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3920 Capital Mall Dr SW
Suite 200
Olympia, WA 98502-8701
Phone (360) 459-7282

601 McPhee Rd SW
BLDG 1
Olympia, WA 98502-5080
Phone (564) 669-5050

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP70009126WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Medical Center Physicians LLC Current Accepting new patients
Capital Medical Center Physicians LLC CurrentSince Aug 28, 2025 Accepting new patients
Olympia Family Medicine, Inc. Past Accepting new patients

Locations

3920 Capital Mall Dr SW
Ste 200
Olympia, WA 98502
Phone (360) 459-7282

Interoperability endpoints

  • Direct secure messaging: jsison856326@direct.multicare.org

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1749081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749081600000",
    "number": "1780578765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2227 79TH AVE SE",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985016803",
            "telephone_number": "206-422-6857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2227 79TH AVE SE",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985016803",
            "telephone_number": "206-422-6857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISON",
        "first_name": "JACLYN",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-05",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP70009126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACLYN",
            "last_name": "FERRER",
            "middle_name": "NICOLE",
            "prefix": "MISS",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tumwater, WA

Sources for this page

Verify at the official NPI Registry.