Provider Demographics
NPI:1902386923
Name:JESSICA ARDERN-WILSON, ND
Entity Type:Organization
Organization Name:JESSICA ARDERN-WILSON, ND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARDERN-WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:206-359-0434
Mailing Address - Street 1:1313 E MAPLE ST STE 102
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-5755
Mailing Address - Country:US
Mailing Address - Phone:360-738-3230
Mailing Address - Fax:360-738-4955
Practice Address - Street 1:1313 E MAPLE ST STE 102
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-5755
Practice Address - Country:US
Practice Address - Phone:360-738-3230
Practice Address - Fax:360-738-4955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2042587Medicaid