Provider Demographics
NPI:1285155044
Name:NONOG, JEMMA (ARNP, CNM)
Entity type:Individual
Prefix:MS
First Name:JEMMA
Middle Name:
Last Name:NONOG
Suffix:
Gender:F
Credentials:ARNP, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15416 40TH AVE W APT 34
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98087-6114
Mailing Address - Country:US
Mailing Address - Phone:206-300-6764
Mailing Address - Fax:
Practice Address - Street 1:1231 116TH AVE NE STE 950
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3832
Practice Address - Country:US
Practice Address - Phone:425-454-3366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-02
Last Update Date:2017-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60764379367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife