Individual
JESSICA L DEPAEPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11511 NE 10TH ST, BELLEVUE, WA 98004-8578
(425) 502-3000
Mailing address
PO BOX 24584, SEATTLE, WA 98124-0584
(425) 656-4255
(425) 656-4003
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
MD00038693
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
185389
WA ST LABOR&IND PROV #
WA
01
—
3056DE
REGENCE B/S PROV #
WA
05
—
8257065
—
WA
01
—
930093398
TRAVELERS MEDICARE #
WA
Enumeration date
06/02/2006
Last updated
03/30/2021
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