Provider Demographics
NPI:1043610371
Name:HEJTMANEK, JENNIFER ANNE (NP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANNE
Last Name:HEJTMANEK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1732
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98041-1732
Mailing Address - Country:US
Mailing Address - Phone:505-850-2219
Mailing Address - Fax:
Practice Address - Street 1:600 UNIVERSITY ST
Practice Address - Street 2:SUITE 1200
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1176
Practice Address - Country:US
Practice Address - Phone:505-850-2219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-22
Last Update Date:2014-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP 60490356363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care