Individual provider Active NPI

Alexis Jeanlefon Watson, LPN

  • Licensed Practical Nurse
  • Lakewood, WA
National Provider Identifier
1922684612
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LP00046252 Issued in WA
Practice address
8803 Terrace Rd SW
Lakewood, WA 98498-4659
Phone
(235) 844-4523
Fax
(235) 302-3923
NPI assigned
Mar 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LP00046252 WA Primary

Addresses

Primary practice location

8803 Terrace Rd SW
Lakewood, WA 98498-4659

Mailing address

6711 159TH St E
Puyallup, WA 98375-7417
Phone (253) 472-2153

Other identifiers 1

IdentifierTypeStateIssuer
239541MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://mail.google.com/mail/u/0/#inbox

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LP00046252WAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1922684612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6711 159TH ST E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983757417",
            "telephone_number": "253-472-2153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8803 TERRACE RD SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984984659",
            "telephone_number": "235-844-4523",
            "fax_number": "235-302-3923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "ALEXIS",
        "middle_name": "JEANLEFON",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-22",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WA",
            "license": "LP00046252",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "239541",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://mail.google.com/mail/u/0/#inbox",
            "affiliation": "N",
            "endpointDescription": "Email",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "8803 Terrace Rd SW",
            "city": "Lakewood",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984984659",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lakewood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2021; 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.