JENNIFER LEE BOMBERGER – Mental Health Counselor, NPI 1871855221

JENNIFER LEE BOMBERGER is a healthcare provider. based in Goldendale, Washington. specializing in MENTAL HEALTH COUNSELOR. They hold a License No. LH60650503 (WA). The NPI Number for JENNIFER LEE BOMBERGER is 1871855221

Main info

Female
Sole Proprietor
15 Years Of Experience
Accepts Medicare Assignment
Name
JENNIFER LEE BOMBERGER
NPI
1871855221
Phone
(541) 910-2932
Address
402 ALLISON WAY
Enumeration Date
12 June 2012
Last Update Date
14 December 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5097734017
Graduation Year
2011 (15 years ago)
PAC ID
7214371210
Group Practice PAC ID
0648164269
Professional Enrollment ID
I20240218000141
Address ID
WA986209059GO317XXWAYX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness75
Years active:13State licenses:1Digital endpointsOther names

1,452 MENTAL HEALTH COUNSELOR in WA

Provider Addresses for JENNIFER LEE BOMBERGER

  • 402 ALLISON WAY

    GOLDENDALE, WA 986209231

    Phone: (541) 910-2932

    Type: Mailing

  • 915 S COLUMBUS AVE

    GOLDENDALE, WA 986209068

    Phone: (541) 910-2932

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-02-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240218000141IMental Health CounselorWATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 98620)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0648164269View full group profile
NameSpecialtyState
Family Practice, Preventive MedicineNM
Physician AssistantMT
Pain ManagementWA
Internal MedicineWA
Nurse PractitionerTN
O P T O M E T R YWA
-WA
Cardiovascular Disease (Cardiology)OR
Internal Medicine, Cardiovascular Disease (Cardiology)OR
Physician AssistantWA

Reviews

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Frequently asked questions

What is JENNIFER LEE BOMBERGER's NPI number?
JENNIFER LEE BOMBERGER's NPI is 1871855221 — the number used across U.S. healthcare to identify this provider.
Would JENNIFER LEE BOMBERGER appear as active to a payer?
You can treat JENNIFER LEE BOMBERGER as active for directory purposes; confirm clinical privileges separately.
What expertise is attributed to JENNIFER LEE BOMBERGER?
JENNIFER LEE BOMBERGER's specialty line reads Mental Health Counselor. Clinical services aligned with this taxonomy classification.
Where in Washington is JENNIFER LEE BOMBERGER registered?
Use Goldendale, Washington as the headline location for JENNIFER LEE BOMBERGER here.
Can I trust this NPI listing for JENNIFER LEE BOMBERGER?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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