Jessica Sage Blank Mendonsa, PA-C
Physician Assistant in Wailuku, HI. Individual provider (NPI-1).
NPI number1124458930
StatusActive
Last updated in NPPESJan 27, 2022
Details
- NPI
- 1124458930
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Jessica Sage Blank Mendonsa
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 14, 2013
- Certification date
- Jan 27, 2022
- Last updated
- Jan 27, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | AMD588 | HI | Yes |
| 174H00000X | Health Educator | – | – | |
| 363A00000X | Physician Assistant | – | WA |
Practice location
2120 Kaohu StWailuku, HI 96793-2205
Phone 808-377-4734 · Fax 808-377-4734
Mailing address
2120 Kaohu StWailuku, HI 96793-2205
Phone 808-377-4734
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All 35 Physician Assistant providers in Wailuku · All 1,418 providers in Wailuku
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