Individual provider Active NPI

Jason Edward Vestal, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Spokane, WA
National Provider Identifier
1851899215
Registry record updated Nov 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP60814161 Issued in WA
Practice address
104 S Freya St Ste Green210
Spokane, WA 99202-4862
Phone
(509) 368-9863
Fax
(509) 587-1575
NPI assigned
Jan 30, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP60814161 WA Primary

Addresses

Primary practice location

104 S Freya St Ste Green210
Spokane, WA 99202-4862

Mailing address

104 S Freya St Ste Green212
Spokane, WA 99202-4862
Phone (509) 368-9863

Other practice location 1

4456 W Upriver Dr
Coeur D Alene, ID 83814-7893
Phone (208) 285-3413

Other identifiers 1

IdentifierTypeStateIssuer
1851899215MedicaidWA

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
I20180228000183 WA Practitioner - Nurse Practitioner 8820359235 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Beyond Behavioral Health LLCGroup PAC ID 3274951579, 5 clinicians

Practice addresses (Care Compare)

104 S Freya St
210 Green Flag BLDG.
Spokane, WA 99202-4879
Phone (509) 964-1590

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Beyond Behavioral Health LLC CurrentSince Oct 30, 2023 Accepting new patients
Frontier Behavioral Health Psychiatric/Mental Health CurrentSince Feb 20, 2018 Accepting new patients

Locations

131 S Division St
Spokane, WA 99202
Phone (509) 532-2000

107 S Division St
Spokane, WA 99202
Phone (509) 383-4651

104 S Freya St
Ste 210
Spokane, WA 99202
Phone (509) 368-9863

Organizations & group practices 2

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": "1517270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764028800000",
    "number": "1851899215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 S FREYA ST STE GREEN212",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992024862",
            "telephone_number": "509-368-9863",
            "fax_number": "509-587-1575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 S FREYA ST STE GREEN210",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992024862",
            "telephone_number": "509-368-9863",
            "fax_number": "509-587-1575"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4456 W Upriver Dr",
            "address_purpose": "LOCATION",
            "city": "Coeur D Alene",
            "state": "ID",
            "postal_code": "838147893",
            "country_code": "US",
            "telephone_number": "208-285-3413",
            "fax_number": "208-470-4625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VESTAL",
        "first_name": "JASON",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-01-30",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP60814161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1851899215",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.