Provider Demographics
NPI:1447893045
Name:BURSEY, JESSICA JORDAN (PA-C)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:JORDAN
Last Name:BURSEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 COOPER POINT RD SW STE 100
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-1172
Mailing Address - Country:US
Mailing Address - Phone:360-596-4800
Mailing Address - Fax:360-596-4801
Practice Address - Street 1:1200 COOPER POINT RD SW STE 100
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-1172
Practice Address - Country:US
Practice Address - Phone:360-596-4800
Practice Address - Fax:360-596-4801
Is Sole Proprietor?:No
Enumeration Date:2019-10-26
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60990181363A00000X
NC0010-09491363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant