Physician Compare National (NPI:1922023209)

HEALTHCARE PROVIDER: JENNIFER CROWE TOLO M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1922023209
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4284627050
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20040415000367
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	TOLO
	Individual professional last name
Provider First Name	JENNIFER
	Individual professional first name
Provider Middle Name	C
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1994
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1603 116TH AVE NE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 110
	Group Practice or individual's line 2 address
City	BELLEVUE
	Group Practice or individual's city
State	WA
	Group Practice or individual's state
Zip Code	980043009
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	500051
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	OVERLAKE HOSPITAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y