Individual
JILL KRISTINE NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3927 RUCKER AVE, EVERETT, WA 98201-4833
(425) 339-5422
Mailing address
7600 EVERGREEN WAY, EVERETT, WA 98203-6421
(206) 860-5414
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA61042871
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA61042871
WASHINGTON PHYSICIAN ASSISTANT LICENSE
WA
Enumeration date
06/12/2020
Last updated
06/18/2026
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