Healthcare Provider Details

I. General information

NPI: 1750120846
Provider Name (Legal Business Name): JESSICA SWANBERG ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2024
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16300 MILL CREEK BLVD STE 201
MILL CREEK WA
98012-1286
US

IV. Provider business mailing address

2210 117TH AVE SE
LAKE STEVENS WA
98258-7313
US

V. Phone/Fax

Practice location:
  • Phone: 360-421-7858
  • Fax: 888-830-3279
Mailing address:
  • Phone: 360-421-7858
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN00142317
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP61562959
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: