Provider Demographics
NPI:1902355084
Name:YOST, JESSTINE COLETTE (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:JESSTINE
Middle Name:COLETTE
Last Name:YOST
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:JESSTINE
Other - Middle Name:
Other - Last Name:YOST
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:5426 ROAD 68 STE D278
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-5268
Mailing Address - Country:US
Mailing Address - Phone:509-567-6450
Mailing Address - Fax:888-722-5709
Practice Address - Street 1:37 COLUMBIA POINT DR
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-4375
Practice Address - Country:US
Practice Address - Phone:509-300-1500
Practice Address - Fax:888-722-5709
Is Sole Proprietor?:No
Enumeration Date:2016-09-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA60704747363A00000X
WAOA61011052363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2071060Medicaid