Provider Demographics
NPI:1174012223
Name:WRIGHT, JACQUELINE JANE (ARNP, DNP, WHNP-BC)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:JANE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:ARNP, DNP, WHNP-BC
Other - Prefix:
Other - First Name:JACQUELINE
Other - Middle Name:JANE
Other - Last Name:CORDOVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP, DNP, WHNP-BC
Mailing Address - Street 1:PO BOX 24547
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-0547
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1515 MARTIN LUTHER KING JR WAY
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-3933
Practice Address - Country:US
Practice Address - Phone:253-779-3904
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-04
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60824126363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health