Individual
JESSICA LYNN PANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4800 SAND POINT WAY NE, SEATTLE, WA 98105-3901
(206) 987-2000
Mailing address
PO BOX 5371, RC-504, SEATTLE, WA 98145-5005
(206) 987-8438
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
DR.0060594
CO
208000000X
Pediatrics Physician
Primary
MD61158278
WA
2080C0008X
Child Abuse Pediatrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114312360
—
WA
Enumeration date
04/04/2015
Last updated
06/29/2021
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