=====================================================
General NPI Number Information
=====================================================
NPI Number | 1205279890
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | VERONICA JESSICK M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/12/2013
-----------------------------------------------------
Last Update Date | 12/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 315 W 9TH AVE STE 200
-----------------------------------------------------
City | SPOKANE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 99204-2501
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 509-444-8200
-----------------------------------------------------
Fax | 509-444-7806
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 731 N IRON BRIDGE WAY
-----------------------------------------------------
City | SPOKANE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 99202-4926
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 509-444-8888
-----------------------------------------------------
Fax | 509-444-7806
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | MD60614620
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------