Individual
JACLYN MAHLSTEDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1135-116TH AVENUE NE, SUITE 200, BELLEVUE, WA 98004
(520) 324-2160
(520) 324-1460
Mailing address
MS 315010, PO BOX 3947, SEATTLE, WA 98124-3947
(425) 467-3655
(425) 835-6388
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
60820546
WA
363LF0000X
Family Nurse Practitioner
Primary
AP60820546
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2145072
—
WA
05
—
791187
—
AZ
Enumeration date
02/08/2013
Last updated
05/14/2020
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