Active NPI
Jane Wilson, LICSW
- Clinical Social Worker
- Edgewood, WA
National Provider Identifier
1972142008
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 10005 24TH St E
Edgewood, WA 98371-2130 - Phone
- (253) 376-7238
- NPI assigned
- Jan 7, 2020
- Sex
- Female
- 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 Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
10005 24TH St E
Edgewood, WA 98371-2130
Mailing address
2779 81St Avenue CT E
Puyallup, WA 98371-3430
Phone (253) 376-7238
Other practice location 1
275 Bronson Way NE
Renton, WA 98056-4030
Phone (425) 235-2800
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq | Health Information Exchange (HIE) |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1578355200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675209600000",
"number": "1972142008",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2779 81ST AVENUE CT E",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983713430",
"telephone_number": "253-376-7238"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10005 24TH ST E",
"city": "EDGEWOOD",
"state": "WA",
"postal_code": "983712130",
"telephone_number": "253-376-7238"
}
],
"practiceLocations": [
{
"address_1": "275 Bronson Way NE",
"address_purpose": "LOCATION",
"city": "Renton",
"state": "WA",
"postal_code": "980564030",
"country_code": "US",
"telephone_number": "425-235-2800",
"fax_number": "877-516-9184",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILSON",
"first_name": "JANE",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-01-07",
"last_updated": "2023-02-01",
"certification_date": "2023-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
"affiliation": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "275 Bronson Way NE",
"city": "Renton",
"state": "WA",
"country_code": "US",
"postal_code": "980564030",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Edgewood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.