MEDICARE: JENNA NHAN VO PMHNP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP61624174	WA

General Provider Information

NPI Number	:	1699448969
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNA NHAN VO PMHNP

Provider Business Mailing Address
First Line	:	19435 68TH AVE S STE S102
Second Line	:
City	:	KENT
State	:	WA
Zip	:	98032-2114
Country	:	US
Telephone Number	:	714-345-0300
Fax Number	:

Provider Business Practice Location Address
First Line	:	19435 68TH AVE S STE S102
Second Line	:
City	:	KENT
State	:	WA
Zip	:	98032-2114
Country	:	US
Telephone Number	:	714-345-0300
Fax Number	:

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

Provider Enumeration Date	:	07/31/2021
Last Update Date	:	01/17/2025

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