Basic Information
| Provider Information | |||||||||
| NPI: | 1760511232 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHILLING | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | ROSE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1101 MADISON STREET | ||||||||
| Address2: | SUITE 1050 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2065150000 | ||||||||
| FaxNumber: | 2065150001 | ||||||||
| Practice Location | |||||||||
| Address1: | 1101 MADISON STREET | ||||||||
| Address2: | SUITE 1050 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2065150000 | ||||||||
| FaxNumber: | 2065150001 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/02/2007 | ||||||||
| LastUpdateDate: | 10/01/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367A00000X | AP30004825 | WA | N | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife | 363LW0102X | AP30004825 | WA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Women's Health |
ID Information
| ID | Type | State | Issuer | Description | 9624016 | 05 | WA | MEDICAID |