Provider Demographics
NPI:1841981891
Name:RIENSTRA, JESSICA FAYE (ARNP, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:FAYE
Last Name:RIENSTRA
Suffix:
Gender:F
Credentials:ARNP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 WESTVIEW PL
Mailing Address - Street 2:
Mailing Address - City:NOOKSACK
Mailing Address - State:WA
Mailing Address - Zip Code:98276-8264
Mailing Address - Country:US
Mailing Address - Phone:360-777-6870
Mailing Address - Fax:
Practice Address - Street 1:402 WESTVIEW PL
Practice Address - Street 2:
Practice Address - City:NOOKSACK
Practice Address - State:WA
Practice Address - Zip Code:98276-8264
Practice Address - Country:US
Practice Address - Phone:360-927-5803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-18
Last Update Date:2024-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61466194363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health