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Individual
MS. JESSICA MONA BHAVSAR
Active
Individual
MS. JESSICA MONA BHAVSAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
57708
CA
363A00000X
Physician Assistant
C0004962
MD
363A00000X
Physician Assistant
PA60636778
WA
363AM0700X
Medical Physician Assistant
PA60636778
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2061716
—
WA
01
—
G000188100
GROUP PTAN(K)
WA
Enumeration date
11/27/2012
Last updated
10/26/2020
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