Provider Demographics
NPI:1861024689
Name:BRINGMAN, JESSICA ERIN (CNP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:ERIN
Last Name:BRINGMAN
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 189
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:WA
Mailing Address - Zip Code:99403-0189
Mailing Address - Country:US
Mailing Address - Phone:509-769-2211
Mailing Address - Fax:509-769-2210
Practice Address - Street 1:1119 HIGHLAND AVE STE 6
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:WA
Practice Address - Zip Code:99403-2836
Practice Address - Country:US
Practice Address - Phone:509-769-2211
Practice Address - Fax:509-751-9406
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-10
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCNP-63152363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health