Provider Demographics
NPI:1467440693
Name:AHRONI, JESSIE H (PHD, ARNP)
Entity Type:Individual
Prefix:DR
First Name:JESSIE
Middle Name:H
Last Name:AHRONI
Suffix:
Gender:F
Credentials:PHD, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3824 NE 155TH ST
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST PARK
Mailing Address - State:WA
Mailing Address - Zip Code:98155-7738
Mailing Address - Country:US
Mailing Address - Phone:206-365-1234
Mailing Address - Fax:526-385-8476
Practice Address - Street 1:125 130TH ST SE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-6400
Practice Address - Country:US
Practice Address - Phone:425-385-2263
Practice Address - Fax:425-385-8476
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-12
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30001768363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMA1201259OtherDEA