Provider Demographics
NPI:1437174364
Name:PASCHALL, JI HYUN LEE (ARNP)
Entity Type:Individual
Prefix:
First Name:JI HYUN
Middle Name:LEE
Last Name:PASCHALL
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 1:4800 SAND POINT WAY NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105
Mailing Address - Country:US
Mailing Address - Phone:206-987-4427
Mailing Address - Fax:206-987-3946
Practice Address - Street 1:4800 SAND POINT WAY NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-3901
Practice Address - Country:US
Practice Address - Phone:206-987-4427
Practice Address - Fax:206-987-3946
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30005174363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKNP979WAOtherAK MEDICAID
MT4300949OtherMT MEDICAID
ID806602100OtherID MEDICAID
WA9627936Medicaid
ID806602100OtherID MEDICAID
WAP28849Medicare UPIN