Individual
JORDANA Z. GRUSSGOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
201 16TH AVE E, SEATTLE, WA 98112-5226
(206) 326-3000
Mailing address
201 16TH AVE E, SEATTLE, WA 98112-5226
(206) 326-3000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP30006858
WA
363LF0000X
Family Nurse Practitioner
Primary
AP30006858
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0207211
L&I PIN
WA
01
—
59663U
REGENCE BLUE SHIELD PIN
WA
05
—
9643388
—
WA
Enumeration date
07/06/2006
Last updated
05/11/2021
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