MEDICARE: JESSICA DELLA READY ARNP, CNM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367A00000X	Advanced Practice Midwife	AP61625086	WA

General Provider Information

NPI Number	:	1407670482
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA DELLA READY ARNP, CNM

Provider Business Mailing Address
First Line	:	270 PINE CREEK RD
Second Line	:
City	:	TONASKET
State	:	WA
Zip	:	98855-9773
Country	:	US
Telephone Number	:	509-861-8162
Fax Number	:

Provider Business Practice Location Address
First Line	:	435 MAPLE ST
Second Line	:
City	:	OMAK
State	:	WA
Zip	:	98841-9374
Country	:	US
Telephone Number	:	509-861-8162
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2024
Last Update Date	:	11/14/2024

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