Individual
JESSICA ANN SISU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
19200 N KELSEY ST, MONROE, WA 98272-1431
(360) 794-9101
Mailing address
1321 COLBY AVE OFC, EVERETT, WA 98201-1665
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60899586
WA
363AM0700X
Medical Physician Assistant
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/24/2018
Last updated
07/22/2021
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