Physician Assistant
JENNIFER CASTELLUCCIO PAC
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1679561435 · enumerated 2005-10-06 · record updated 2021-08-17. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Addresses and phones
- Practice location 26458 MAPLE VALLEY BLACK DIAMOND RD SE, MAPLE VALLEY, WA, 98038 (425) 690-3460 Fax (425) 690-9460 Google Maps Apple Maps OpenStreetMap
- Mailing address 3600 LIND AVE SW, SUITE 100 ATTN CREDENTIALING, RENTON, WA, 98057-4970 (425) 690-2715 Google Maps Apple Maps OpenStreetMap
Specialties
- Physician Assistant, Medical 363AM0700X · License OA10000132 WA
- Physician Assistant 363A00000X · Primary · License OA10000132 WA
Published links
In this directory
Locations and evidence
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Practice location
MAPLE VALLEY, WA, 98038
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.