Individual
JENNA ROSE WIXON GENACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1959 NE PACIFIC ST, SEATTLE, WA 98195
(206) 598-3300
Mailing address
325 9TH AVE # 359895, SEATTLE, WA 98104-2420
(206) 744-2155
(206) 744-8516
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD61087147
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/13/2018
Last updated
07/07/2021
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