Provider Demographics
NPI:1851316921
Name:MCGINNIS, JEAN K (ARNP)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:K
Last Name:MCGINNIS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 SAND POINT WAY NE
Mailing Address - Street 2:W7830
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-3901
Mailing Address - Country:US
Mailing Address - Phone:206-987-2521
Mailing Address - Fax:206-987-5111
Practice Address - Street 1:4800 SAND POINT WAY NE
Practice Address - Street 2:W7830
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-3901
Practice Address - Country:US
Practice Address - Phone:206-987-2521
Practice Address - Fax:206-987-5111
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30005432363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKNP686WAMedicaid
MT4301408Medicaid
WA9627910Medicaid
MT4301408Medicaid
AKNP686WAMedicaid