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General NPI Number Information
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NPI Number | 1295657419
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Entity Type | Organization
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Legal Business Name | JACQUELINE GREGORY PYCHIATRIC NURSE PRACTITIONER PLLC
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Dates
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Enumeration Date | 07/28/2026
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Last Update Date | 07/28/2026
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Provider Practice Location Address
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Address Line | 1769 NACHES WENAS RD LOT 156
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City | SELAH
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State | WA
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Zip | 98942-1448
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Country | US
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Telephone | 509-854-8722
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Fax | 307-202-4873
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Provider Business Mailing Address
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Address Line | 1769 NACHES WENAS RD LOT 156
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City | SELAH
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State | WA
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Zip | 98942-1448
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Country | US
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Telephone | 509-854-8722
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Fax | 307-202-4873
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Authorized Official
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Title or Position | OWNER
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Name | MS. JACQUELINE GREGORY
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Credential | PHD, FNP-C PMHNP-BC
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Telephone | 509-854-8722
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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