Provider Demographics
NPI:1942240601
Name:FESLER, JOANNA LINN (ARNP)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:LINN
Last Name:FESLER
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 1:505 S 336TH ST
Mailing Address - Street 2:SUITE 600
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-6328
Mailing Address - Country:US
Mailing Address - Phone:253-838-6180
Mailing Address - Fax:253-838-6418
Practice Address - Street 1:10631 EIGHTH AVE NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-7298
Practice Address - Country:US
Practice Address - Phone:206-364-2050
Practice Address - Fax:206-361-5722
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30007014363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1056FEOtherBSWA
WA0210281OtherLIWA
WA9645466Medicaid
WAG8861499Medicare PIN
WA0210281OtherLIWA
WAP00366406Medicare PIN