Individual
JESSICA RAE PAVOLKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1200 S CEDAR CREST BLVD, ALLENTOWN, PA 18103-6202
(610) 402-8000
Mailing address
5958 ASH CT, SLATINGTON, PA 18080-3135
(484) 695-5112
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA060320
PA
363A00000X
Physician Assistant
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104438717-0001
—
PA
Enumeration date
07/25/2018
Last updated
02/20/2026
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