Individual
JESTYN M CUMMINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
1501 PACIFIC AVE, TACOMA, WA 98402-3302
(253) 680-6018
Mailing address
1501 PACIFIC AVE, TACOMA, WA 98402-3302
(253) 680-6018
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP60044793
WA
363L00000X
Nurse Practitioner
RN00168049
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0246357
STATE L&I
WA
01
—
0255762
STATE L&I
WA
01
—
0291783
STATE L&I
WA
Enumeration date
09/05/2008
Last updated
05/02/2016
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