Active NPI
Jennifer Ann Young
- Nurse Practitioner
- Olympia, WA
National Provider Identifier
1972001675
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- AP60832489
- Practice address
- 413 Lilly Rd NE
Olympia, WA 98506-5133 - Phone
- (360) 493-4069
- Fax
- (360) 486-6436
- NPI assigned
- Jan 28, 2018
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | AP60832489 | WA | Primary |
Addresses
Primary practice location
413 Lilly Rd NE
Olympia, WA 98506-5133
Mailing address
PO Box 3360
Portland, OR 97208-3360
Other practice location 1
413 Lilly Rd NE
Olympia, WA 98506-5133
Phone (360) 491-9480
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)
- Enrolled
- Credentials
- Nurse Practitioner
Interoperability endpoints
- jyoung82712@direct.multicare.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1517097600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1523923200000",
"number": "1972001675",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3360",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972083360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "413 LILLY RD NE",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985065133",
"telephone_number": "360-493-4069",
"fax_number": "360-486-6436"
}
],
"practiceLocations": [
{
"address_1": "413 Lilly Rd NE",
"address_purpose": "LOCATION",
"city": "Olympia",
"state": "WA",
"postal_code": "985065133",
"country_code": "US",
"telephone_number": "360-491-9480",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "YOUNG",
"first_name": "JENNIFER",
"middle_name": "ANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-28",
"last_updated": "2018-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WA",
"license": "AP60832489",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Olympia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.