Provider Demographics
NPI:1174922199
Name:ARMSTRONG, JACOB WESLEY (ARNP)
Entity type:Individual
Prefix:
First Name:JACOB
Middle Name:WESLEY
Last Name:ARMSTRONG
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:J WESLEY
Other - Middle Name:
Other - Last Name:ARMSTRONG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ARNP
Mailing Address - Street 1:521 S WELLER ST #266
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104
Mailing Address - Country:US
Mailing Address - Phone:206-261-5415
Mailing Address - Fax:
Practice Address - Street 1:9650 15TH AVE SW
Practice Address - Street 2:SUITE 100
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98106-2820
Practice Address - Country:US
Practice Address - Phone:206-965-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-14
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60382287163W00000X
WAAP60515710363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse