Active NPI
Andrew Jensen, CRNA
- Certified Registered Nurse Anesthetist
- Longview, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- AP60633494
- Practice address
- 1615 Delaware St
Longview, WA 98632-2367 - Phone
- (360) 414-2000
- Fax
- (360) 414-7638
- NPI assigned
- Oct 23, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 43-557134-111 | KS | |
| Certified Registered Nurse Anesthetist | 367500000X | AP60633494 | WA | Primary |
Addresses
Primary practice location
1615 Delaware St
Longview, WA 98632-2367
Mailing address
1526 Legend Trail Dr Unit a
Lawrence, KS 66047-2555
Phone (503) 804-9498
Other practice location 1
1700 SW 7th St
Topeka, KS 66606-2489
Phone (785) 295-8000
Other practice location 2
2312 NE 129th St
Vancouver, WA 98686-3236
Phone (360) 514-7060
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq | Health Information Exchange (HIE) | Northwest Permanente PC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA, OR
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1615 Delaware St
Longview, WA 98632-2367
Phone (360) 636-4814
Hospital & facility affiliations
- Peacehealth St John Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 43-557134-111 | KS | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of the Northwest | Current | Accepting new patients | |
| Columbia Anesthesia Group P S | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of the Northwest | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Peacehealth | Current | Accepting new patients | |
| Peacehealth | Current | Accepting new patients |
Locations
10180 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2880
10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946
1015 NW 22nd Ave
Portland, OR 97210
Phone (503) 413-7582
2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400
7300 SW Childs Rd
Ste A
Tigard, OR 97224
Phone (360) 828-5396
1615 Delaware St
Longview, WA 98632
Phone (360) 363-4818
400 NE Mother Joseph Pl
Vancouver, WA 98664
Phone (360) 514-2000
2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985
2312 NE 129th St
Vancouver, WA 98686
Phone (360) 546-8950
Interoperability endpoints
- ajensen254174@direct.peacehealth.org
Organizations & group practices 5
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.
-
- Multi-Specialty Clinic/Center
- Longview, WA
- NPI 1720056187
-
- General Acute Care Hospital
- Vancouver, WA
- NPI 1134178999
-
- General Practice Physician
- Portland, OR
- NPI 1184786527
Nurse Anesthetist, Certified Registered
-
- Clinic/Center
- Hillsboro, OR
- NPI 1942718622
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Longview, WA
- NPI 1073510277
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1350950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681776000000",
"number": "1831442235",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1526 LEGEND TRAIL DR UNIT A",
"city": "LAWRENCE",
"state": "KS",
"postal_code": "660472555",
"telephone_number": "503-804-9498"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1615 DELAWARE ST",
"city": "LONGVIEW",
"state": "WA",
"postal_code": "986322367",
"telephone_number": "360-414-2000",
"fax_number": "360-414-7638"
}
],
"practiceLocations": [
{
"address_1": "1700 SW 7th St",
"address_purpose": "LOCATION",
"city": "Topeka",
"state": "KS",
"postal_code": "666062489",
"country_code": "US",
"telephone_number": "785-295-8000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2312 NE 129th St",
"address_purpose": "LOCATION",
"city": "Vancouver",
"state": "WA",
"postal_code": "986863236",
"country_code": "US",
"telephone_number": "360-514-7060",
"fax_number": "360-729-3162",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JENSEN",
"first_name": "ANDREW",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-10-23",
"last_updated": "2023-04-18",
"certification_date": "2023-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "KS",
"license": "43-557134-111",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "WA",
"license": "AP60633494",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Northwest Permanente PC",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "10180 SE Sunnyside Rd",
"city": "Clackamas",
"state": "OR",
"country_code": "US",
"postal_code": "970158970",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Longview, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.