JILLIAN C S LONGWAY (NPI# 1669875993) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669875993 |
| Entity Type | Individual |
| Full Name | JILLIAN C S LONGWAY |
| Other Name | JILLIAN C SMITH |
| Credential | CPNP |
| Practice Address |
11102 Sunrise Blvd E Ste 103 Puyallup WA 98374 |
| Mailing Address |
11102 Sunrise Blvd E Ste 103 Puyallup WA 98374-8846 |
| Practice Telephone | 2538488797 |
| Mailing Telephone | 2538488797 |
| Enumeration Date | 2014-10-01 |
| Last Update Date | 2018-07-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | RN60840002 | WA | Nursing Service Providers |
| N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
AP60849416 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
SP017177 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
19231 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
11102 SUNRISE BLVD E STE 103 |
| City | PUYALLUP |
| State | WA |
| Zip Code | 98374 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073041364 | Lisa Ann Oberlander | Nurse Practitioner | 11102 Sunrise Blvd E Ste 103, Puyallup, WA 98374-8846 | 2017-05-31 |
| 1407242530 | Taylor Ryan Mclain | Pediatrics | 11102 Sunrise Blvd E Ste 103, Puyallup, WA 98374 | 2015-04-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073173977 | Courtney Yant | Registered Nurse | 300 3rd St Se, Puyallup, WA 98374 | 2019-06-13 |
| 1013480508 | Tracy Pina | Massage Therapist | 16909 123rd Ave E, Puyallup, WA 98374 | 2019-01-07 |
| 1922524917 | Edith M Wood | Registered Nurse | 13517 152nd St Ct E, Puyallup, WA 98374 | 2017-08-21 |
| 1427302025 | Nadeem Jaffer | Internal Medicine | 3800 3rd St. Se, Puyallup, WA 98374 | 2012-11-04 |
| 1851605356 | Madigan Army Medical Ctr | Clinic/Center | 15600 Meridan Ave, Sunrise Village Center, East Puyallup, WA 98374 | 2010-07-27 |
| 1326368135 | Matt Karl Jahns | Massage Therapist | 2402 20th St Se, Puyallup, WA 98374 | 2010-06-03 |
| 1982833208 | Roxy Sturgeon | Speech-Language Pathologist | 2309 43rd Ave Se, Puyallup, WA 98374 | 2009-07-08 |
| 1497921191 | Morgan Counseling Services Inc. | Substance Abuse Rehabilitation Facility | 10312 120th Street East, Suite #3, Puyallup, WA 98374 | 2008-05-02 |
| 1700055795 | Walter Royal Patterson Jr. | Registered Nurse | 11102 Sunrise Blvd. E., Ste. 103, Woodcreek Healthcare, Puyallup, WA 98374 | 2008-02-25 |
| 1336331487 | Jo Ellen Marie Houser-hunt | Speech-Language Pathologist | 12698 115th Ave Ct E, Puyallup, WA 98374 | 2007-08-13 |
| Find all providers in zip 98374 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336260280 | Roberta Louise Salveson | Nurse Practitioner | 319 5th St Nw, Puyallup, WA 98371 | 2007-04-02 |
| 1124105408 | Shawna Hood | Nurse Practitioner | 1706 S Meridian, Suite 120, Puyallup, WA 98371-7516 | 2006-11-01 |
| 1922026178 | Theresa J Harris | Nurse Practitioner | 1706 S Meridian Ste 130, Puyallup, WA 98371-7516 | 2006-07-17 |
| 1467965954 | Heather Buzbee | Nurse Practitioner | 10217 125th Street Ct E, Puyallup, WA 98374-2761 | 2017-11-07 |
| 1073041364 | Lisa Ann Oberlander | Nurse Practitioner | 11102 Sunrise Blvd E Ste 103, Puyallup, WA 98374-8846 | 2017-05-31 |
| 1689116691 | Pediatric Health Care | Nurse Practitioner | 1420 3rd St Se, Ste. 200, Puyallup, WA 98372-3730 | 2016-11-08 |
| 1649712548 | Tera L. Johnson | Nurse Practitioner | 1420 3rd St Se, Ste. 200, Puyallup, WA 98372-3730 | 2016-11-08 |
| 1558716043 | Emily Winn | Nurse Practitioner | 11102 Sunrise Blvd E, Suite 103, Puyallup, WA 98374-8846 | 2016-05-03 |
| 1801293949 | Devyn Catherine Cameron | Nurse Practitioner | 11102 Sunrise Blvd E, Suite 103, Puyallup, WA 98374-8846 | 2014-12-03 |
| 1750639704 | Evergreen Children's Clinic | Nurse Practitioner | 1910 Meridian St S, Suite A, Puyallup, WA 98371-7531 | 2012-08-23 |
| Find all providers in PUYALLUP | ||||
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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.