Individual
JENNIFER JANE NORDSTROM-ZUARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1221 MADISON ST STE 1220, SEATTLE, WA 98104-1356
(206) 215-4250
(206) 215-4252
Mailing address
PO BOX 25608, SALT LAKE CITY, UT 84125-0608
(206) 320-4476
(206) 568-7043
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60111601
WA
363AM0700X
Medical Physician Assistant
PA1048
NV
363AM0700X
Medical Physician Assistant
PA60111601
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100512418
—
NV
05
—
8554693
—
WA
01
—
CD8128
GROUP RR #
WA
01
—
PA60111601
WA LICENSE
WA
Enumeration date
07/07/2005
Last updated
03/17/2018
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