Provider Demographics
NPI:1942537493
Name:ROOK, JODI LEIGH (PA-C)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:LEIGH
Last Name:ROOK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JODI
Other - Middle Name:LEIGH
Other - Last Name:DAIGEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:16259 SYLVESTER RD SW STE 401
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166-3059
Mailing Address - Country:US
Mailing Address - Phone:206-823-1004
Mailing Address - Fax:206-309-3319
Practice Address - Street 1:16259 SYLVESTER RD SW STE 401
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166
Practice Address - Country:US
Practice Address - Phone:206-823-1004
Practice Address - Fax:206-309-3319
Is Sole Proprietor?:No
Enumeration Date:2009-11-04
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53663363A00000X
WAPA60057919363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical