Individual
JILL KRISTINE NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9709 3RD AVE NE, SEATTLE, WA 98115-2062
(206) 329-1760
Mailing address
1145 BROADWAY FL 2, SEATTLE, WA 98122-4201
(253) 552-4900
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
01/19/2022
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