Individual
JESSICA EVANS FUGATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
825 EASTLAKE AVE E, SEATTLE, WA 98109-4405
(206) 520-5700
Mailing address
825 EASTLAKE AVE E, SEATTLE, WA 98109-4405
(206) 520-5700
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60598918
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1881004927
—
WA
Enumeration date
04/29/2014
Last updated
06/27/2016
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