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Individual
JESSICA J KING
Active
Individual
JESSICA J KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10004077
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0147109
LIWA
WA
01
—
0171360
LIWA
WA
01
—
1594KI
BSWA
WA
01
—
2164KI
BSWA
WA
05
—
8348898
—
WA
Enumeration date
06/12/2006
Last updated
11/19/2012
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