MRS. JENNIFER LYNN WILLCOX (NPI# 1306965546) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306965546 |
| Entity Type | Individual |
| Full Name | MRS. JENNIFER LYNN WILLCOX |
| Other Name | MRS. JENNIFER LYNN COOK |
| Credential | PA-C |
| Practice Address |
20200 54th Ave W Lynnwood WA 98036-6318 |
| Mailing Address |
20021 88th Ave W Edmonds WA 98026-6620 |
| Practice Telephone | 4256726400 |
| Mailing Telephone | 4256723189 |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2008-07-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA10003620 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MEDICARE PTAN | G8858574 | 01 | |
| MEDICARE PTAN | G8858575 | 01 | |
| WA | MEDICARE PTAN | G8872586 | 01 |
| WA | 8879273 | 05 | |
| MEDICARE PTAN | G8858576 | 01 | |
| NCCPA CERTIFICATE NUMBER | 1035425 | 01 | |
| L&I | 0178761 | 01 | |
| WA | DEA | MC1038303 | 01 |
| WA | MEDICARE PTAN | G8858577 | 01 |
| MEDICARE PTAN | G8858578 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851808794 | Jennifer Willcox | Optometrist | 2744 Bartlett Blvd, Bartlett, TN 38134-4530 | 2017-12-31 |
| Street Address |
20200 54TH AVE W |
| City | LYNNWOOD |
| State | WA |
| Zip Code | 98036-6318 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396711487 | Elisa Marie Frost Granger | Family Medicine | 20200 54th Ave W, Lynnwood, WA 98036-6318 | 2006-02-27 |
| 1205440625 | Lisa Szuwei Li | Registered Nurse | 20200 54th Ave W, Lynnwood, WA 98036-6318 | 2020-09-02 |
| 1063988012 | Andrea Lyn Coleman | Registered Nurse | 20200 54th Ave W, Lynnwood, WA 98036-6318 | 2018-10-17 |
| 1679090260 | Karielle B Jewell | Physician Assistant | 20200 54th Ave W, Lynnwood, WA 98036-6318 | 2017-08-24 |
| 1821444811 | Deanna Irene Dickerman | Dermatology | 20200 54th Ave W, Lynnwood, WA 98036-6318 | 2016-05-09 |
| 1598129827 | Taneev Escamilla | Family Medicine | 20200 54th Ave W, Lynnwood, WA 98036-6318 | 2016-04-13 |
| 1386000990 | Oscar Alonso Hernandez | Physical Therapist | 20200 54th Ave W, Lynnwood, WA 98036-6318 | 2016-01-12 |
| 1588080485 | Naomi Kim | Physical Therapist | 20200 54th Ave W, Lynnwood, WA 98036-6318 | 2014-03-16 |
| 1568753531 | Kaiser Foundation Health Plan of Washington | Clinic/Center | 20200 54th Ave W, Lynnwood, WA 98036-6318 | 2011-04-26 |
| 1033418819 | Derek Steven Sylte | Family Medicine | 20200 54th Ave W, Lynnwood, WA 98036-6318 | 2011-03-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396342630 | Zachary Perry | Behavior Technician | 4100 Veterans Way, Unit 100, Lynnwood, WA 98036 | 2020-10-08 |
| 1942832795 | Alexis Michelle Solomon-winne | Behavior Technician | 4100 Veterans Way Unit 100 Lynnwood, Wa 98036 United S, Lynnwood, WA 98036 | 2020-02-10 |
| 1881239028 | Endc Pllc | Psychologist | 19217 36th Ave W. Suite 219, Lynnwood, WA 98036 | 2019-11-12 |
| 1225507866 | Kyung Suk Seo | Massage Therapist | 18904 Hwy 99, Ste. K, Lynnwood, WA 98036 | 2018-11-13 |
| 1790270197 | Kabal Sriviboon | Behavior Technician | 20818 44th Ave W Suite 270, Lynnwood, WA 98036 | 2018-06-27 |
| 1992206148 | Kendal Ilyse Borison | Behavioral Analyst | 4100 194th Se, Suite 100, Lynnwood, WA 98036 | 2018-02-23 |
| 1205352515 | Doug Brant | Registered Nurse | 19931 Cypress Way, Lynnwood, WA 98036 | 2017-08-17 |
| 1588184980 | Evergreen Recovery Centers-lynnwood Detox | Substance Abuse Rehabilitation Facility | 20508 56th Ave W, Lynnwood, WA 98036 | 2017-06-27 |
| 1699213439 | Patrick J. Pacyga | Dentist | 19620 Wa-99, Suite 106, Lynnwood, WA 98036 | 2017-02-01 |
| 1134676646 | Fiona Green | Occupational Therapy Assistant | 21503 8th Place W, A, Lynnwood, WA 98036 | 2016-09-01 |
| Find all providers in zip 98036 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477920833 | Junhui Zou | Physician Assistant | 4111 194th St Sw, Lynnwood, WA 98036-4604 | 2015-09-01 |
| 1902910268 | Jin Liang Guo | Physician Assistant | 4320 196th St Sw Ste D, Lynnwood, WA 98036-6753 | 2006-08-17 |
| 1386622546 | Geordie Mcgill Glass | Physician Assistant | 19020 33rd Ave W Ste 210, Lynnwood, WA 98036-4748 | 2006-01-06 |
| 1245218429 | Lynda Jo Storm | Physician Assistant | 19020 33rd Ave W Ste 210, Lynnwood, WA 98036-4748 | 2006-01-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033735618 | Gavin Guard | Physician Assistant | 818 Mullis St Ste 6, Friday Harbor, WA 98250-7986 | 2020-06-19 |
| 1578110862 | Kaitlin E. Brotman | Physician Assistant | 315 Holton Ave Ste 100, Yakima, WA 98902-3245 | 2019-08-21 |
| 1700345196 | Kara Lynn Kime | Physician Assistant | 1200 Cooper Point Rd Sw Ste 100, Olympia, WA 98502-1172 | 2019-03-15 |
| 1679056824 | Katharine Loco-marshall | Physician Assistant | 4816 She-nah-num Drive, Olympia, WA 98513 | 2018-09-13 |
| 1841791274 | Sjs, Pllc | Physician Assistant | 900 Ocean Beach Hwy Ste B, Longview, WA 98632-4013 | 2018-02-21 |
| 1063928448 | Heidi April | Physician Assistant | 1410 N Pittsburgh St, Building A, Kennewick, WA 99336-8211 | 2017-12-20 |
| 1194251983 | Christopher Joseph Stanley | Physician Assistant | 1010 Ne Lilac St Apt 301, Issaquah, WA 98029-7878 | 2017-05-11 |
| 1366993362 | Vanessa Julie Iglesias Mehta | Physician Assistant | 5128 Yelm Hwy Se, Suite E, Lacey, WA 98503 | 2016-10-14 |
| 1801344601 | Jessica Ann Pettitt | Physician Assistant | 21200 Ne 190th Ct, Battle Ground, WA 98604-9636 | 2016-09-21 |
| 1407300098 | Joshua David Evans | Physician Assistant | 9040 Jackson Ave Mchj Clq C, Tacoma, WA 98431-1100 | 2016-08-11 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.