Provider Demographics
NPI:1477231611
Name:DINES, JESSICA MAY (ARNP, RN)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:MAY
Last Name:DINES
Suffix:
Gender:F
Credentials:ARNP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23005 EDMONDS WAY UNIT B
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98020-5045
Mailing Address - Country:US
Mailing Address - Phone:206-890-0633
Mailing Address - Fax:
Practice Address - Street 1:6837 29TH AVE NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-7236
Practice Address - Country:US
Practice Address - Phone:206-948-0918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-07
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN61096917163W00000X
WAAP61480557363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse