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NPI Code Detail

MEDICARE: JESSICA A. WESCH MD

MEDICARE: JESSICA A. WESCH MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianMD00043986WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1689745689
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA A. WESCH MD
Provider Business Mailing Address
First Line : 1200 12TH AVE S
Second Line : SUITE 901
City : SEATTLE
State : WA
Zip : 98144-2712
Country : US
Telephone Number : 206-548-3114
Fax Number : 206-762-6355
Provider Business Practice Location Address
First Line : 10030 SW 210TH ST
Second Line :
City : VASHON
State : WA
Zip : 98070-6584
Country : US
Telephone Number : 206-463-3671
Fax Number : 206-463-3613
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2006
Last Update Date : 08/23/2016

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