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Individual

ISMAIL JATTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-S

Contact information

Practice address
27500 168TH PL SE, COVINGTON, WA 98042-5563
(425) 690-3435
(425) 690-9435
Mailing address
27500 168TH PL SE, COVINGTON, WA 98042-5563
(425) 690-3435
(425) 690-9435

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60696675
WA
363AM0700X
Medical Physician Assistant
PA60696675
WA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2068463
WA
Enumeration date
09/16/2015
Last updated
02/06/2026
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