Healthcare Provider Details

I. General information

NPI: 1730939760
Provider Name (Legal Business Name): JESSICA ABGARYAN MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2024
Last Update Date: 03/25/2024
Certification Date: 03/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10050 NE 10TH ST UNIT 512
BELLEVUE WA
98004-4176
US

IV. Provider business mailing address

10050 NE 10TH ST UNIT 512
BELLEVUE WA
98004-4176
US

V. Phone/Fax

Practice location:
  • Phone: 818-434-0207
  • Fax:
Mailing address:
  • Phone: 818-434-0207
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: