JENNIFER A CASTELLUCCIO (NPI# 1679561435) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679561435 |
| Entity Type | Individual |
| Full Name | JENNIFER A CASTELLUCCIO |
| Credential | PAC |
| Practice Address |
26458 Maple Valley Black Diamond Rd Se Maple Valley WA 98038 |
| Mailing Address |
Po Box 34876 Seattle WA 98124-1876 |
| Practice Telephone | 4256565577 |
| Practice Fax Number | 4256565595 |
| Mailing Telephone | 4256565412 |
| Mailing Fax Number | 4256565096 |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2014-09-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | OA10000132 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
26458 MAPLE VALLEY BLACK DIAMOND RD SE |
| City | MAPLE VALLEY |
| State | WA |
| Zip Code | 98038 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457837486 | Nissa Loving Kisler | Nurse Practitioner | 26458 Maple Valley Black Diamond Rd Se, Maple Valley, WA 98038 | 2018-07-12 |
| 1124478870 | Laura Lynn Aguilar | Family Medicine | 26458 Maple Valley Black Diamond Rd Se, Maple Valley, WA 98038 | 2016-06-14 |
| 1083012900 | Aaron Von Krueger | Physician Assistant | 26458 Maple Valley Black Diamond Rd Se, Maple Valley, WA 98038-8350 | 2014-12-09 |
| 1053560524 | Kristen Elizabeth Drury | Dietitian, Registered | 26458 Maple Valley Black Diamond Rd Se, Maple Valley, WA 98038-8350 | 2008-09-09 |
| 1831282821 | Laurie M Anderton | Emergency Medicine | 26458 Maple Valley Black Diamond Rd Se, Maple Valley, WA 98038 | 2006-10-02 |
| 1548274715 | Lawrence J Madewell | Family Medicine | 26458 Maple Valley Black Diamond Rd Se, Maple Valley, WA 98038 | 2006-07-27 |
| 1366426405 | Rodney Tyson Riedel | Family Medicine | 26458 Maple Valley Black Diamond Rd Se, Maple Valley, WA 98038-8350 | 2005-12-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619456357 | Ryan Koichi Taniguchi | Physical Therapist | 26837 Maple Valley Black Diamond Rd Se Ste 200, Maple Valley, WA 98038 | 2018-08-13 |
| 1841722311 | Michelle Atkinson | Behavior Technician | 26846 226th Pl Se, Maple Valley, WA 98038 | 2017-04-03 |
| 1285019828 | Blue River Counseling, LLC | Counselor | 22728 228th Avenue Se, Maple Valley, WA 98038 | 2015-07-24 |
| 1619356060 | Victoria Labrie | Specialist/Technologist | 24961 230th Pl Se, Maple Valley, WA 98038 | 2015-05-19 |
| 1114328523 | Scott Joseph Akers | Physical Therapist | 26837 Maple Valley Black Diamond Road, Suite 200, Maple Valley, WA 98038 | 2014-09-05 |
| 1487069647 | Thomas A. Holt Dds Pllc | Dentist | 27016 Maple Valley Black Diamond Road South East, Maple Valley, WA 98038 | 2014-06-26 |
| 1548515216 | Stirewalt PC | Dentist | 24040 Se Kent Kangley Rd, Suite E200, Maple Valley, WA 98038 | 2012-07-19 |
| 1124399183 | Samantha Halfen | Counselor | 26828 Maple Valley Hwy, Suite #152, Maple Valley, WA 98038 | 2012-01-24 |
| 1326336868 | Troy Aaron Nordyke | Physical Therapist | 26837 Maple Valley Highway, Suite 200, Maple Valley, WA 98038 | 2011-07-19 |
| 1598074510 | Luna Healthcare, LLC | Audiologist-Hearing Aid Fitter | 22010 Se 248th Street, Maple Valley, WA 98038 | 2010-09-27 |
| Find all providers in zip 98038 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| 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 perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255804654 | Tao Liang | Physician Assistant | 23745 225th Way Se Ste 201, Maple Valley, WA 98038 | 2019-01-08 |
| 1083012900 | Aaron Von Krueger | Physician Assistant | 26458 Maple Valley Black Diamond Rd Se, Maple Valley, WA 98038-8350 | 2014-12-09 |
| 1548347297 | Constance I Barthel | Physician Assistant | 24080 Se Kent Kangley Rd, Maple Valley, WA 98038-6801 | 2006-11-01 |
| 1447342027 | Constance P Hood | Physician Assistant | 24080 Se Kent Kangley Rd, Maple Valley, WA 98038-6801 | 2006-09-29 |
| 1770525537 | John A Tomchick | Physician Assistant | 23846 Se Kent Kangley Rd, Maple Valley, WA 98038-6848 | 2006-06-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831790591 | Bailey Mantha-nagrant | Physician Assistant | 7912 170th Ave Ne Unit 301, Redmond, WA 98052-0907 | 2020-11-07 |
| 1518567791 | Addison Christine Richert | Physician Assistant | 121 Kingfisher Pl, Port Hadlock, WA 98339-8733 | 2020-10-28 |
| 1992312177 | Robert Monsees | Physician Assistant | 490 Packwood Ln, Ellensburg, WA 98926-8027 | 2020-09-30 |
| 1649887548 | Jesse E Davis | Physician Assistant | 3512 Serene Way, Lynnwood, WA 98087-5202 | 2020-09-25 |
| 1558977066 | Kimberly Ho | Physician Assistant | 23004 88th Ave W, Edmonds, WA 98026-8616 | 2020-09-20 |
| 1770198954 | Ashish Chaudhary | Physician Assistant | 1215 Dexter Ave N Apt 704, Seattle, WA 98109-3567 | 2020-09-14 |
| 1144835422 | Juleeann Stocking | Physician Assistant | 1517 17th Ave S, Seattle, WA 98144-3522 | 2020-09-13 |
| 1891309555 | Andrew Allyn Bloom | Physician Assistant | 5889 Bow St, Bow, WA 98232-8620 | 2020-09-01 |
| 1558973909 | Margaret Webster | Physician Assistant | 6501 36th Ave Nw, Seattle, WA 98117-6010 | 2020-08-18 |
| 1033720495 | Riley Richardson | Physician Assistant | 1008 E Windemere Ct, Spokane, WA 99223-6228 | 2020-08-11 |
| Find all providers with the same taxonomy | ||||
| City | MAPLE VALLEY |
| Zip Code | 98038 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.