JESSICA KIERSTEN MATTSON (NPI# 1669637807) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669637807 |
| Entity Type | Individual |
| Full Name | JESSICA KIERSTEN MATTSON |
| Other Name | MISS JESSICA KIERSTEN REY |
| Credential | PA-C |
| Practice Address |
24 N Church St 403 Wailuku HI 96793-1680 |
| Practice Telephone | 6033211099 |
| Mailing Telephone | 6033211099 |
| Enumeration Date | 2008-07-28 |
| Last Update Date | 2019-05-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336764570 | Jessica Kathleen Mattson | Registered Nurse | 107 Wisconsin Ave, Cochrane, WI 54622-7311 | 2020-06-13 |
| 1518505551 | Jessica Mattson | Counselor | 1801 W End Ave Ste 520, Nashville, TN 37203-2518 | 2019-12-19 |
| 1831646579 | Jessica Mattson | Marriage & Family Therapist | 11340 W Olympic Blvd, Suite 210, Los Angeles, CA 90064-1608 | 2016-09-09 |
| Street Address |
24 N CHURCH ST 403 |
| City | WAILUKU |
| State | HI |
| Zip Code | 96793-1680 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316908296 | Michael Ellsworth Clarke | Oral & Maxillofacial Surgery | 24 N Church St, #206, Wailuku, HI 96795 | 2006-03-30 |
| 1801110119 | Sonya Hansen | Internal Medicine | 24 N Church St, Suite 403, Wailuku, HI 96793-1680 | 2010-03-16 |
| 1649463639 | Hawaii Endocrine Associates LLC | Internal Medicine | 24 N Church St, Suite 403, Wailuku, HI 96793-1680 | 2007-08-22 |
| 1073644068 | Michael E Clarke Ddsms Inc | Dentist | 24 N Church St, Suite 206, Wailuku, HI 96793-1680 | 2007-03-08 |
| 1487705695 | Michael Lynn Ellis | Dentist | 24 N Church St, Suite 206, Wailuku, HI 96793-1680 | 2007-01-15 |
| 1720173214 | Till Peter Hansen | Internal Medicine | 24 N Church St, Suite 403, Wailuku, HI 96793-1680 | 2006-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699384701 | Laura Covey | Massage Therapist | Wailuku Community Acupuncture, 33 Central Ave, Wailuku, HI 96793 | 2020-07-24 |
| 1750902839 | Massage Therapy and Wellness of Hawai, LLC | Massage Therapist | Massage Therapy and Wellness of Hawaii, 219 Hookahi St Suite 108, Wailuku, HI 96793 | 2020-04-30 |
| 1790329084 | Milba Rojas Melchor | Technician | 932 Wailupe Drive, Wailuku, HI 96793 | 2019-10-30 |
| 1669973863 | Chad Adolpho | Massage Therapist | 95 Mahalani Street, Room 21, Wailuku, HI 96793 | 2018-02-22 |
| 1548785520 | Hookaulike Wellness LLC | Registered Nurse | 720 Kealii Drive, Wailuku, HI 96793 | 2017-08-10 |
| 1932585072 | Back & Body Clinic of Hi, LLC | Massage Therapist | 81 Central Avenue, Wailuku, HI 96793 | 2015-07-30 |
| 1558765719 | Maui Cancer Clinic, Inc. | Clinic/Center | 24 North Church Street Suite 308, Wailuku, HI 96793 | 2014-10-17 |
| 1609275262 | Maui Memorial Medical Center | General Acute Care Hospital | 85 Maui Lani Parkway, Wailuku, HI 96793 | 2014-08-20 |
| 1558780072 | Mental Health Kokua | Community/Behavioral Health | 503 -a Ua Place, Wailuku, HI 96793 | 2014-04-11 |
| 1538584545 | Mental Health Kokua | Assisted Living Facility | 503 Ua Pl, Iao Valley, Wailuku, Maui, HI 96793 | 2014-02-27 |
| Find all providers in zip 96793 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194728139 | Susan S Stewart | Physician Assistant | Maui Medical Group, 2180 Main Street, Wailuku, HI 96793 | 2005-05-23 |
| 1154951499 | Philip Michael Tongg Jr. | Physician Assistant | 2180 Main St, Wailuku, HI 96793-1625 | 2020-01-24 |
| 1194061549 | Stephanie Manzella | Physician Assistant | 55 Maui Lani Pkwy, Wailuku, HI 96793-2416 | 2012-12-12 |
| 1972854099 | Tim Taikyo Kaneda | Physician Assistant | 2180 Main St, Wailuku, HI 96793-1625 | 2012-09-28 |
| 1326312877 | Reshma Lalwani | Physician Assistant | 2180 Main St, Wailuku, HI 96793-1625 | 2012-03-01 |
| 1003050261 | Arthur Ruben Sakakihara - Chavarria | Physician Assistant | 2180 Main St, Wailuku, HI 96793-1625 | 2009-04-30 |
| 1548420490 | Leonard Jay Ferguson | Physician Assistant | 2180 Main St, Wailuku, HI 96793-1666 | 2008-06-13 |
| 1629169628 | Lisa Virginia Kemp | Physician Assistant | 2180 Main St, Wailuku, HI 96793-1625 | 2006-09-27 |
| 1780785618 | Stephen Koshel | Physician Assistant | 2180 Main St, Wailuku, HI 96793-1625 | 2006-09-25 |
| 1487623369 | Kazue T Johansen | Physician Assistant | 2180 Main St, Wailuku, HI 96793-1625 | 2006-03-14 |
| Find all providers in WAILUKU | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.