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Individual
ELLEN B JANKOWSKI
Active
Individual
ELLEN B JANKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA001161
ME
363A00000X
Physician Assistant
PA10004431
WA
363AM0700X
Medical Physician Assistant
PA001161
ME
363AM0700X
Medical Physician Assistant
PA10004431
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0166563
L&I PIN
WA
05
—
272170099
—
ME
01
—
54807U
REGENCE BLUE SHIELD PIN
WA
05
—
8324659
—
WA
Enumeration date
08/01/2006
Last updated
09/26/2020
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