MEDICARE: JESSICA CARLENE ASHCRAFT

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
1	106S00000X	Behavior Technician		WA

General Provider Information

NPI Number	:	1942135280
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA CARLENE ASHCRAFT

Provider Business Mailing Address
First Line	:	13407 SE 172ND PL
Second Line	:
City	:	RENTON
State	:	WA
Zip	:	98058
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	13407 SE 172ND PL
Second Line	:
City	:	RENTON
State	:	WA
Zip	:	98058-6155
Country	:	US
Telephone Number	:	214-436-9178
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2026
Last Update Date	:	06/17/2026

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