Banasik, Jacquelyn Lou

Banasik, Jacquelyn Lou is an sole proprietor health care provider with primary practice located at 103 E Spokane Falls Blvd Nurs 447, Spokane WA 99202. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Banasik, Jacquelyn Lou can be contacted via phone (509) 324-7269.

Contact Information

Primary practice address
103 E Spokane Falls Blvd Nurs 447 Spokane WA 99202
Phone: (509) 324-7269
Fax: (509) 324-7341
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X AP30003996 Washington
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X AP30003996 Washington

Profile Details

NPI number 1174518021
LBN Legal business name Banasik, Jacquelyn Lou
Credentials MN ARNP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 16th, 2005
Last updated May 22nd, 2018 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174518021 NPPES
Washington MEDICAID 9623026

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