Provider Demographics
NPI:1376019208
Name:PARDO, JESSIE (PA-C)
Entity Type:Individual
Prefix:
First Name:JESSIE
Middle Name:
Last Name:PARDO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1001 WILSON BLVD APT 1101
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22209-2261
Mailing Address - Country:US
Mailing Address - Phone:561-389-1684
Mailing Address - Fax:
Practice Address - Street 1:2300 N PERSHING DR STE 204
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22201-1428
Practice Address - Country:US
Practice Address - Phone:703-255-5070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-18
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant