Type 1 · Individual ✓ Active NPI ✓ Valid NPI checksum

Jon Derik Mortensen, PAC

Medical Physician Assistant in Lakewood, WA · enumerated 2006.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1407930456

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Registry record

Entity type Individual (Type 1)

Name Jon Derik Mortensen

Credential PAC

Sex Male

Practice address 10510 Gravelly Lake Dr., Community Health Care - Lakewood Clinic, Lakewood, WA, 98499

Phone (253) 589-7030

Fax (253) 589-7033

Enumeration date Oct 25, 2006

Last updated in NPPES Jun 14, 2012

Taxonomy & licenses

363AM0700X Medical Physician Assistant Physician Assistants & Advanced Practice Nursing Providers · License PA10005073 (WA) Primary

Other identifiers

Identifier	Type	State	Issuer
8469256	Medicaid	WA	-

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

What is the NPI number for Jon Mortensen?

The National Provider Identifier (NPI) for Jon Mortensen is 1407930456, a Type 1 (individual) record in the CMS NPPES registry.

Where does Jon Mortensen practice?

The practice location on file with NPPES is in Lakewood, WA. Providers can have multiple locations; NPPES lists the primary practice address.

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2012-06-14.