# JESSICA M S VITTENGL

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1073707980
- **Gender:** F
- **Credential:** ARNP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | AP30007851 | WA | Yes |
| 363LA2100X | Acute Care Nurse Practitioner | AP30007851 | WA | — |

## Other

- **Enumeration date:** 09/04/2007
- **Last updated:** 07/21/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0164VI | REGENCE BLUE SHIELD | WA |
| 01 | — | 0280023 | L&I AND CRIME VICTIMS | WA |
| 05 | — | 1073707980 | — | WA |
| 05 | — | 9654005 | — | WA |
| 01 | — | AF03 | TRI WEST (TRICARE) | WA |