Individual provider Active NPI

Jane E Takeda, DNP, FNP-BC, BSN, RN

  • Family Nurse Practitioner
  • Vancouver, WA
National Provider Identifier
1992395230
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP61477773 Issued in WA
Practice address
7410 Delaware LN
Vancouver, WA 98664-1408
Phone
(360) 566-4402
Fax
(360) 566-4406
NPI assigned
Jan 21, 2021
Last updated
Jan 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP61477773 WA Primary
Registered Nurse 163W00000X RN61420190 WA
Medical-Surgical Registered Nurse 163WM0705X 202009638 OR

Addresses

Primary practice location

7410 Delaware LN
Vancouver, WA 98664-1408

Mailing address

7410 Delaware LN
Vancouver, WA 98664-1408
Phone (360) 566-4402

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231213000291 WA Practitioner - Nurse Practitioner 6901255140 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sea Mar Community Health CentersGroup PAC ID 7315831161, 235 clinicians

Practice addresses (Care Compare)

4111 Alderwood Mall Blvd
Lynnwood, WA 98036-6765
Phone (425) 616-4100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN61420190WAMDRegistered Nurse
202009638ORMDMedical-Surgical Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Sea Mar Community Health Centers Family Current Accepting new patients
Sea-Mar Community Health Center CurrentSince Sep 27, 2023 Accepting new patients
Sea Mar Community Health Centers Registered Nurse CurrentSince Sep 27, 2023 Accepting new patients

Locations

4111 Alderwood Mall Blvd
Lynnwood, WA 98036
Phone (425) 616-4100

1400 N Laventure Rd
Mount Vernon, WA 98273
Phone (360) 428-4075

1040 S Henderson St
Seattle, WA 98108
Phone (206) 763-5210

7410 Delaware Ln
Vancouver, WA 98664
Phone (360) 566-4402

Interoperability endpoints

  • Direct secure messaging: jtakeda735242@direct.multicare.org

Organizations & group practices 3

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 3

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": "1611187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1992395230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7410 DELAWARE LN",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986641408",
            "telephone_number": "360-566-4402",
            "fax_number": "360-566-4406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7410 DELAWARE LN",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986641408",
            "telephone_number": "360-566-4402",
            "fax_number": "360-566-4406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAKEDA",
        "first_name": "JANE",
        "middle_name": "E",
        "credential": "DNP, FNP-BC, BSN, RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-21",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61477773",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN61420190",
            "primary": false
        },
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "OR",
            "license": "202009638",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.