Provider Demographics
NPI:1669501235
Name:TABBARA, JESSICA ELIZABETH (ND)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:ELIZABETH
Last Name:TABBARA
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2503 MONTAVISTA PL W
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98199-3724
Mailing Address - Country:US
Mailing Address - Phone:206-234-1944
Mailing Address - Fax:
Practice Address - Street 1:1227 N ALLEN PL
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-7412
Practice Address - Country:US
Practice Address - Phone:206-624-6627
Practice Address - Fax:206-525-5933
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA602445307OtherUNIFIED BUSINESS ID
WA602445307OtherUNIFIED BUSINESS ID