Jesse L Defelice

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

3924 204TH St SW
Lynnwood, WA 98036-6863

Phone

(206) 362-7282

NPI assigned

Apr 2, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jessica Defelice Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1712016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1861244964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13933 113TH AVE NE",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980345308",
            "telephone_number": "845-260-5113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3924 204TH ST SW",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980366863",
            "telephone_number": "206-362-7282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFELICE",
        "first_name": "JESSE",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-02",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "DEFELICE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mary Agnes Debroux, RN
• Kristi Marie Dechairo Ahern
• Catherine Ann Decker
• Sherrin Annette Deen
• Calina M Defebaugh, MS, CCC-SLP
• Sarah Jean Defreitas, MOT, OTR/L
• Diane Defuria, L.M.P.
• Jessica Degamo
• Michael Andrew Degroot, MD
• Daniel Dejenie, RN60804372

• Community Health Worker in Lynnwood, WA
• Providers in Lynnwood, WA by specialty
• Community Health Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.