Individual
JILL E FACCIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
700 NE 87TH AVE, VANCOUVER, WA 98664
(360) 882-2778
(360) 604-1771
Mailing address
700 NE 87TH AVE, VANCOUVER, WA 98664-1913
(360) 882-2778
(360) 604-1771
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
AP60755776
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AP60755776
STATE LICENSE
WA
Enumeration date
11/10/2013
Last updated
07/21/2022
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