=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407370471
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JESSICA N STEINSIEK MD, MPH
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/01/2017
-----------------------------------------------------
Last Update Date | 12/09/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2211 RIMLAND DR STE 320
-----------------------------------------------------
City | BELLINGHAM
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98226-6014
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-752-5175
-----------------------------------------------------
Fax | 360-756-4805
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 310 SKYCREST DR
-----------------------------------------------------
City | ASHLAND
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97520-1690
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number | MD61599719
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2084P0804X
-----------------------------------------------------
Taxonomy Name | Child & Adolescent Psychiatry Physician
-----------------------------------------------------
License Number | MD210002395
-----------------------------------------------------
License Number State | DC
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 2084P0804X
-----------------------------------------------------
Taxonomy Name | Child & Adolescent Psychiatry Physician
-----------------------------------------------------
License Number | 223138
-----------------------------------------------------
License Number State | AK
-----------------------------------------------------