JILLIAN PENNELL RUTHERFORD PA-C NPI 1255391884

NPI Information

NPI: 1255391884
Provider Name: JILLIAN PENNELL RUTHERFORD, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
1780 NW MYHRE RD
SUITE 2360
SILVERDALE, WA
ZIP 98383
Phone: (360) 662-1110
Get Directions

Jillian Pennell Rutherford, PA-C is a medical physician assistant in Silverdale, WA. Jillian Pennell Rutherford, PA-C NPI is 1255391884. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1780 NW MYHRE RD
SUITE 2360
SILVERDALE, WA
ZIP 98383-676
Phone: (360) 662-1110

The NPI 1255391884 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/27/2006 and was last updated on 10/1/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	PA10003965	WASHINGTON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	P44259	MEDICARE UPIN
2	8802052	MEDICARE ID-TYPE UNSPECIFIED

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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