MEDICARE: JENNIFER NIELSEN RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN00132894	WA

General Provider Information

NPI Number	:	1760330781
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER NIELSEN RN

Provider Business Mailing Address
First Line	:	1135 116TH AVE NE STE 450
Second Line	:
City	:	BELLEVUE
State	:	WA
Zip	:	98004-4623
Country	:	US
Telephone Number	:	425-289-3130
Fax Number	:	425-289-3133

Provider Business Practice Location Address
First Line	:	1135 116TH AVE NE STE 450
Second Line	:
City	:	BELLEVUE
State	:	WA
Zip	:	98004-4623
Country	:	US
Telephone Number	:	425-289-3130
Fax Number	:	425-289-3133

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/17/2026
Last Update Date	:	03/17/2026

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