Provider Demographics
NPI:1447749866
Name:DEELENA, JAYA L (ARNP, DNP, FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:JAYA
Middle Name:L
Last Name:DEELENA
Suffix:
Gender:F
Credentials:ARNP, DNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 E KINCAID ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98274-4127
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3823 172ND ST NE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-7735
Practice Address - Country:US
Practice Address - Phone:360-657-8840
Practice Address - Fax:360-848-4598
Is Sole Proprietor?:No
Enumeration Date:2018-05-02
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60854657363L00000X
WAAP60854657363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner