Provider Demographics
NPI:1700880150
Name:O'NEILL, JAY P (PA-C)
Entity type:Individual
Prefix:MR
First Name:JAY
Middle Name:P
Last Name:O'NEILL
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:1018 CAPITOL WAY S
Mailing Address - Street 2:STE 300
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-1212
Mailing Address - Country:US
Mailing Address - Phone:360-486-6508
Mailing Address - Fax:
Practice Address - Street 1:800 N 5TH AVE
Practice Address - Street 2:STE 101
Practice Address - City:SEQUIM
Practice Address - State:WA
Practice Address - Zip Code:98382-3045
Practice Address - Country:US
Practice Address - Phone:360-582-2690
Practice Address - Fax:360-582-2691
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2016-09-08
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Provider Licenses
StateLicense IDTaxonomies
WAPA10004128363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant