Jennifer A Castelluccio in Maple Valley - Physician Assistant
Jennifer A Castelluccio - NPI 1679561435
Jennifer A Castelluccio is a Physician Assistant in Maple Valley, Washington. Jennifer A Castelluccio practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Jennifer A Castelluccio is 1679561435. The last update date is 2021-08-17.
Jennifer A Castelluccio's current location address is 26458 Maple Valley Black Diamond Rd Se, Maple Valley, Washington. You can contact this provider via phone number 4256903460 and fax number 4256909460. The mailing address for Jennifer A Castelluccio is 26458 Maple Valley Black Diamond Rd Se, Maple Valley, Washington. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jennifer A Castelluccio |
|---|---|
| Address | 26458 Maple Valley Black Diamond Rd Se, Maple Valley, Washington |
| Phone Number | 4256903460 |
| Fax Number | 4256909460 |
| Sole Proprietor | N |
| Credentials | PAC |
NPI Number Detail
| NPI Number | 1679561435 |
|---|---|
| Provider Enumeration Date | 2005-10-06 |
| Last Updated Date | 2021-08-17 |
Provider Mailing Address Detail
| Address | 26458 Maple Valley Black Diamond Rd Se |
|---|---|
| City | Maple Valley |
| State | Washington (WA) |
| Post Code | 98038 |
| Phone Number | 4256903460 |
| Fax Number | 4256909460 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | OA10000132 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1016090 | WA | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Jennifer A Castelluccio by the Centers for Medicare & Medicaid Services?
The Jennifer A Castelluccio has been assigned the NPI (National Provider Identifier) 1679561435 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Can you provide the Jennifer A Castelluccio's physical address?
The Jennifer A Castelluccio is physically located at 26458 Maple Valley Black Diamond Rd Se, in the city of Maple Valley, WA, with the postal code 98038.
What is Jennifer A Castelluccio's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Jennifer A Castelluccio is Physician Assistant, and the taxonomy code that classifies this field of practice is 363A00000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1679561435 to Jennifer A Castelluccio?
The Centers for Medicare & Medicaid Services originally issued the 1679561435 to Jennifer A Castelluccio on 2005-10-06.
When was the information regarding Jennifer A Castelluccio, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Jennifer A Castelluccio, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2021-08-17.