Healthcare Provider Details

I. General information

NPI: 1649109836
Provider Name (Legal Business Name): JAMI TENNILE ANDERSON MSN APRN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 NE 139TH ST
VANCOUVER WA
98686-2719
US

IV. Provider business mailing address

2525 NE 139TH ST
VANCOUVER WA
98686-2719
US

V. Phone/Fax

Practice location:
  • Phone: 360-882-2778
  • Fax:
Mailing address:
  • Phone: 360-882-2778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP70150540
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN60231540
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: