Individual provider Active NPI

Jenna Alise Williamson, MD

  • Internal Medicine Physician
  • Spokane, WA
National Provider Identifier
1891315149
Registry record updated Jul 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD61423056 Issued in WA
Practice address
624 E Front Ave
Spokane, WA 99202-2139
Phone
(509) 626-9900
NPI assigned
Apr 16, 2020
Last updated
Jul 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD61423056 WA Primary
Student in an Organized Health Care Education/Training ProgramGroup: 193400000X SINGLE SPECIALTY GROUP 390200000X

Addresses

Primary practice location

624 E Front Ave
Spokane, WA 99202-2139

Mailing address

7211 S Moran View St
Spokane, WA 99224-8506
Phone (360) 708-0556

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230719001818 WA Practitioner - Internal Medicine 9234599481 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Washington School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Hospital Medicine Physicians LLCGroup PAC ID 6406805449, 67 clinicians

Practice addresses (Care Compare)

1211 24TH St
Anacortes, WA 98221-2562
Phone (360) 299-1300

1415 E Kincaid St
Mount Vernon, WA 98274-4126
Phone (360) 424-4111

407 14TH Ave SE
Puyallup, WA 98372-3770
Phone (253) 697-4000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
South Sound Inpatient Physicians PLLC Single Specialty Current Accepting new patients
South Sound Inpatient Physicians, PLLC Internal Medicine CurrentSince Jul 1, 2023 Accepting new patients
South Sound Inpatient Physicians PLLC Single Specialty CurrentSince Jul 1, 2023 Accepting new patients
Northwest Hospital Medicine Physicians LLC Single Specialty CurrentSince Jul 1, 2025 Accepting new patients
Public Hospital Dist No 1 Skagit Past Accepting new patients

Locations

120 Brentwood Commons Way
Ste 510
Brentwood, TN 37027
Phone (253) 682-6040

1211 24th St
Anacortes, WA 98221
Phone (360) 293-3181

330 S Stillaguamish Ave
Arlington, WA 98223
Phone (360) 435-2133

3810 Plaza Way
Kennewick, WA 99338
Phone (509) 221-7000

407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000

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, 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": "1586995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688688000000",
    "number": "1891315149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7211 S MORAN VIEW ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992248506",
            "telephone_number": "360-708-0556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 E FRONT AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992022139",
            "telephone_number": "509-626-9900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "JENNA",
        "middle_name": "ALISE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-16",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD61423056",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.