Mahlstede, Jaclyn
Mahlstede, Jaclyn is an individual health care provider with primary practice located at 1135-116Th Avenue Ne Suite 200, Bellevue WA 98004. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Mahlstede, Jaclyn can be contacted via phone (520) 324-2160.Contact Information
Primary practice address
1135-116Th Avenue Ne Suite 200
Bellevue WA 98004
Phone: (520) 324-2160
Fax: (520) 324-1460
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 60820546 | Washington |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | AP60820546 | Washington |
Profile Details
| NPI number | 1659610764 |
|---|---|
| LBN Legal business name | Mahlstede, Jaclyn |
| Credentials | ARNP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 8th, 2013 |
| Last updated | May 14th, 2020 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659610764 | NPPES |
| Washington | MEDICAID | 2145072 | |
| Washington | MEDICAID | 791187 |
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