Active NPI
Zachary Jenkins, PH.D.
- Clinical Psychologist
- Silverdale, WA
National Provider Identifier
1861547739
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1193
- Practice address
- 3431 NW Lowell St
Silverdale, WA 98383-9120 - Phone
- (360) 698-2828
- Fax
- (360) 697-7965
- NPI assigned
- Jan 23, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1193 | WA | Primary |
Addresses
Primary practice location
3431 NW Lowell St
Silverdale, WA 98383-9120
Mailing address
PO Box 2787
Poulsbo, WA 98370-2787
Phone (360) 698-2828
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090615000613 | WA | Practitioner - Clinical Psychologist | 0143370007 | Practice locations: Poulsbo, WA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1982
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
30993 Baltic LN NE
Poulsbo, WA 98370-6800
Phone (360) 698-2828
PO Box
Suite 2787
Poulsbo, WA 98370
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1193 | WA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1861547739",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2787",
"city": "POULSBO",
"state": "WA",
"postal_code": "983702787",
"telephone_number": "360-698-2828",
"fax_number": "306-697-7965"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3431 NW LOWELL ST",
"city": "SILVERDALE",
"state": "WA",
"postal_code": "983839120",
"telephone_number": "360-698-2828",
"fax_number": "360-697-7965"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENKINS",
"first_name": "ZACHARY",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "1193",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Silverdale, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.