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General NPI Number Information
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NPI Number | 1073338851
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Entity Type | Individual
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Provider Name | JESSICA MATHER GC
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Gender | Female
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Dates
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Enumeration Date | 11/18/2024
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Last Update Date | 12/23/2024
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Provider Practice Location Address
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Address Line | 2008 CATON WAY SW STE A2
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City | OLYMPIA
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State | WA
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Zip | 98502-2100
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Country | US
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Telephone | 360-485-0115
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Fax | 844-813-3892
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Provider Business Mailing Address
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Address Line | 2008 CATON WAY SW STE A2
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City | OLYMPIA
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State | WA
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Zip | 98502-2100
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Country | US
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Telephone | 360-485-0115
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Fax | 844-813-3892
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 170300000X
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Taxonomy Name | Genetic Counselor (M.S.)
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License Number | GCP-P-10247795
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 170300000X
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Taxonomy Name | Genetic Counselor (M.S.)
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License Number | GT61604470
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License Number State | WA
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