Provider Demographics
NPI:1891831590
Name:JERGENS, PATRICIA (ARNP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:JERGENS
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 1:707 S GRADY WAY STE 400
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-3246
Mailing Address - Country:US
Mailing Address - Phone:253-350-7523
Mailing Address - Fax:844-864-7148
Practice Address - Street 1:707 S GRADY WAY STE 400
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-3246
Practice Address - Country:US
Practice Address - Phone:253-350-7523
Practice Address - Fax:844-864-7148
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30007485207Q00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine