Healthcare Provider Details

I. General information

NPI: 1003119009
Provider Name (Legal Business Name): JESSICA SWENSON ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2010
Last Update Date: 11/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1231 116TH AVE NE SUITE 950
BELLEVUE WA
98004-3804
US

IV. Provider business mailing address

1231 116TH AVE NE SUITE 950
BELLEVUE WA
98004-3804
US

V. Phone/Fax

Practice location:
  • Phone: 425-454-3366
  • Fax: 425-460-5954
Mailing address:
  • Phone: 425-454-3366
  • Fax: 425-460-5954

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberAP30006896
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: