Provider Demographics
NPI:1225566292
Name:RIPPEY, JILLIAN ALEXA (ARNP)
Entity Type:Individual
Prefix:
First Name:JILLIAN
Middle Name:ALEXA
Last Name:RIPPEY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:JILLIAN
Other - Middle Name:ALEXA
Other - Last Name:KOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9801 FRONTIER AVE SE
Mailing Address - Street 2:
Mailing Address - City:SNOQUALMIE
Mailing Address - State:WA
Mailing Address - Zip Code:98065-5200
Mailing Address - Country:US
Mailing Address - Phone:425-831-2300
Mailing Address - Fax:425-831-3531
Practice Address - Street 1:35020 SE KINSEY ST
Practice Address - Street 2:
Practice Address - City:SNOQUALMIE
Practice Address - State:WA
Practice Address - Zip Code:98065-8992
Practice Address - Country:US
Practice Address - Phone:425-396-7682
Practice Address - Fax:425-396-7694
Is Sole Proprietor?:No
Enumeration Date:2017-06-02
Last Update Date:2017-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60750903363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAP60750903OtherSTATE LICENSE