Healthcare Provider Details

I. General information

NPI: 1710266358
Provider Name (Legal Business Name): JILLIAN TRECIA EDWARDS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2011
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 LILLY RD NE
OLYMPIA WA
98506-5115
US

IV. Provider business mailing address

522 W RIVERSIDE AVE STE N
SPOKANE WA
99201-0581
US

V. Phone/Fax

Practice location:
  • Phone: 360-923-7000
  • Fax:
Mailing address:
  • Phone: 225-663-6683
  • Fax: 253-289-7712

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP60242646
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: