Jennifer A Castelluccio, PAC

NPI #1679561435 in Maple Valley, Washington

Provider Information

NPI Number: 1679561435
Entity Type: Individual
Name: Jennifer A Castelluccio, PAC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PAC
Enumeration Date: Oct 6, 2005
Last Updated: Aug 17, 2021

Practice Location

Address: 26458 MAPLE VALLEY BLACK DIAMOND RD SE
City: Maple Valley
State: Washington
ZIP Code: 98038
Phone: (425) 690-3460

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant - Medical — Medical	363AM0700X
Physician Assistant	363A00000X	Primary

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