Individual
MRS. JESSICA RENEE MARIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1035 116TH AVE NE, BELLEVUE, WA 98004-4604
(425) 688-5759
Mailing address
1035 116TH AVE NE, BELLEVUE, WA 98004-4604
(425) 688-5645
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
6243
AZ
363A00000X
Physician Assistant
Primary
PA.60767796
WA
Other
Enumeration date
09/28/2011
Last updated
03/17/2018
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