Provider Demographics
NPI:1003923863
Name:JAKAWICH, ESTHER C (ARNP)
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:C
Last Name:JAKAWICH
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 1:6718 144TH ST NW
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98332-8738
Mailing Address - Country:US
Mailing Address - Phone:253-857-6166
Mailing Address - Fax:253-851-6333
Practice Address - Street 1:6718 144TH ST NW
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98332-8738
Practice Address - Country:US
Practice Address - Phone:253-857-6166
Practice Address - Fax:253-851-6333
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30003324363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1392208Medicaid
WAE22916Medicare UPIN