Basic Information
| Provider Information | |||||||||
| NPI: | 1063957835 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CASEBEER | ||||||||
| FirstName: | JEN | ||||||||
| MiddleName: | REBECCA | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1200 12TH AVE S STE 901 | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981442712 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2065483058 | ||||||||
| FaxNumber: | 2062620859 | ||||||||
| Practice Location | |||||||||
| Address1: | 1753 NW 56TH ST STE 200 | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981075279 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2067825939 | ||||||||
| FaxNumber: | 2067825934 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/03/2017 | ||||||||
| LastUpdateDate: | 12/15/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/15/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 60375502 | WA | N | Nursing Service Providers | Registered Nurse | 163WA0400X | 60375502 | WA | N | Nursing Service Providers | Registered Nurse | Addiction (Substance Use Disorder) | 163WP0200X | 60375502 | WA | N | Nursing Service Providers | Registered Nurse | Pediatrics | 163WP0808X | 60375502 | WA | N | Nursing Service Providers | Registered Nurse | Psych/Mental Health | 163WP0807X | 60375502 | WA | N | Nursing Service Providers | Registered Nurse | Psych/Mental Health, Child & Adolescent | 163WP0809X | 60375502 | WA | N | Nursing Service Providers | Registered Nurse | Psych/Mental Health, Adult | 163WW0101X | 60375502 | WA | N | Nursing Service Providers | Registered Nurse | Women's Health Care, Ambulatory | 363LF0000X | AP61219445 | WA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.