Provider Demographics
NPI:1003119009
Name:SWENSON, JESSICA (ARNP)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:
Last Name:SWENSON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1231 116TH AVE NE
Mailing Address - Street 2:SUITE 950
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3804
Mailing Address - Country:US
Mailing Address - Phone:425-454-3366
Mailing Address - Fax:425-460-5954
Practice Address - Street 1:1231 116TH AVE NE
Practice Address - Street 2:SUITE 950
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3804
Practice Address - Country:US
Practice Address - Phone:425-454-3366
Practice Address - Fax:425-460-5954
Is Sole Proprietor?:No
Enumeration Date:2010-12-13
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30006896363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1003119009Medicaid
WA1003119009Medicare PIN