Basic Information
| Provider Information | |||||||||
| NPI: | 1518417476 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BROWNFIELD HESS | ||||||||
| FirstName: | MOLLY | ||||||||
| MiddleName: | BETH | ||||||||
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| Credential: | P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | MS 315010 | ||||||||
| Address2: | PO BOX 3947 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981243947 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4254673655 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1135-116TH AVENUE NE | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | BELLEVUE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4802566444 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/04/2016 | ||||||||
| LastUpdateDate: | 03/25/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/25/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AS0400X | 6525 | AZ | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical | 363AS0400X | PA60938034 | WA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical |
ID Information
| ID | Type | State | Issuer | Description | 2132929 | 05 | WA | MEDICAID | 6525 | 01 | AZ | THE ARIZONA REGULATORY BOARD OF PHYSICIAN ASSISTANTS | OTHER |