Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | AP 60490356 | WA |
NPI | 1043610371 |
---|---|
Provider Name | Jennifer Anne Hejtmanek |
First Address | Bothell, WA 98041-1732 |
Second Address | Seattle, WA 98101-1176 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2014 |
Last Update Date | 22/08/2014 |