Provider Demographics
NPI:1437431947
Name:ROWAN, JESSICA M (CNM, ARNP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:M
Last Name:ROWAN
Suffix:
Gender:F
Credentials:CNM, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1812 S J ST
Mailing Address - Street 2:STE 120
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-4964
Mailing Address - Country:US
Mailing Address - Phone:253-207-4890
Mailing Address - Fax:253-207-4871
Practice Address - Street 1:1812 S J ST
Practice Address - Street 2:STE 120
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-4964
Practice Address - Country:US
Practice Address - Phone:253-207-4890
Practice Address - Fax:253-207-4871
Is Sole Proprietor?:No
Enumeration Date:2011-09-12
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00169958163W00000X
WAAP60235010367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0285744OtherSTATE L&I
WAG8904079Medicare PIN