Provider Demographics
NPI:1316332463
Name:ADAMS, JESSICA MICHELLE (ARNP)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:MICHELLE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:MICHELLE
Other - Last Name:BRANDT & MCNURLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:101 NW 12TH AVENUE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:BATTLE GROUND
Mailing Address - State:WA
Mailing Address - Zip Code:98604
Mailing Address - Country:US
Mailing Address - Phone:360-723-0528
Mailing Address - Fax:360-995-0081
Practice Address - Street 1:101 NW 12TH AVENUE
Practice Address - Street 2:SUITE 107
Practice Address - City:BATTLE GROUND
Practice Address - State:WA
Practice Address - Zip Code:98604
Practice Address - Country:US
Practice Address - Phone:360-723-0528
Practice Address - Fax:360-995-0081
Is Sole Proprietor?:No
Enumeration Date:2015-04-04
Last Update Date:2024-07-02
Deactivation Date:2020-12-07
Deactivation Code:
Reactivation Date:2021-01-13
Provider Licenses
StateLicense IDTaxonomies
WAAP 60548136363L00000X
WAAP60548136363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2047122Medicaid