Provider Demographics
NPI:1952965915
Name:DR. JESSICA WENDLING, LLC
Entity Type:Organization
Organization Name:DR. JESSICA WENDLING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ND
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:WENDLING
Authorized Official - Suffix:
Authorized Official - Credentials:ND, LMT
Authorized Official - Phone:248-345-3863
Mailing Address - Street 1:308 1/2 NE 72ND ST
Mailing Address - Street 2:APT 2
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115
Mailing Address - Country:US
Mailing Address - Phone:248-345-3863
Mailing Address - Fax:
Practice Address - Street 1:5401 LEARY AVE NW STE 206
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-4070
Practice Address - Country:US
Practice Address - Phone:206-297-6013
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-25
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center