Active NPI
Jane E Takeda, DNP, FNP-BC, BSN, RN
- Family Nurse Practitioner
- Vancouver, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- AP61477773
- 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, 2025
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| RN61420190 | WA | MD | Registered Nurse |
| 202009638 | OR | MD | Medical-Surgical Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sea Mar Community Health Centers | Family | Current | Accepting new patients |
| Sea-Mar Community Health Center | Current | Accepting new patients | |
| Sea Mar Community Health Centers | Registered Nurse | Current | 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
- 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.
-
dba Sea Mar Community Health Center
- Federally Qualified Health Center (FQHC)
- Aberdeen, WA
- NPI 1811051170
Family
-
- Federally Qualified Health Center (FQHC)
- Spanaway, WA
- NPI 1922624642
Registered Nurse
-
- Federally Qualified Health Center (FQHC)
- Mount Vernon, WA
- NPI 1881742724
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba PeaceHealth SW Heart & Vascular Center
- Cardiovascular Disease Physician
- Vancouver, WA
- NPI 1003194911
Hospital
-
dba PeaceHealth Southwest Medical Center
- General Acute Care Hospital
- Vancouver, WA
- NPI 1134178999
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.